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General Scholarship Application Form: First Last

This document is a general scholarship application form requesting basic contact and academic information. It requests the applicant's name, address, phone number, email, citizenship status, educational details, honors received, extracurricular activities, work or internship experience, and which scholarships they plan to apply for. The applicant must provide a biographical statement and scholarship essay(s), and certify that the information is accurate before submitting the single form to the Scholarship Office for consideration.

Uploaded by

Ken Bi
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103 views3 pages

General Scholarship Application Form: First Last

This document is a general scholarship application form requesting basic contact and academic information. It requests the applicant's name, address, phone number, email, citizenship status, educational details, honors received, extracurricular activities, work or internship experience, and which scholarships they plan to apply for. The applicant must provide a biographical statement and scholarship essay(s), and certify that the information is accurate before submitting the single form to the Scholarship Office for consideration.

Uploaded by

Ken Bi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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General Scholarship Application Form

Name____________________________________________________________________________
First Last

Address__________________________________________________________________________
Street City State Zip Code

Home phone ( )______________Cell phone (___)________________ Email_________________


*EmplID #_____________________________ Gender: _______ Male _______ Female
U.S. Citizen ______Permanent Resident ______ Student Visa _____ Other ______
Nationality_____________________________
Degree: ______ Undergraduate ______ Graduate Status: _____ Full-time ______ Part-time
Major ____________________ Minor ____________________
Number of currently registered credits ______

What scholastic honors or distinctions have you received?


________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

List the most significant extracurricular and community activities (sports, art, music, clubs,
social or public service etc.) in or out of Lehman College, in which you have participated.
Organization Duties/Activities Length of Time Name & Contact Information
Of Supervisor or Faculty Advisor
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
List any internship(s) and/or research experience(s) in which you have participated.
Organization Duties/Activities Length of Time Name & Contact Information
Of Supervisor or Faculty Advisor
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

List any work and/or volunteer experience.

Organization Duties/Activities Length of Time Name & Contact Information


Of Supervisor or Faculty Advisor
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Applying for individual scholarships


Please indicate which scholarship(s) you plan to apply for. Please note that each scholarship requires
a minimum GPA of 3.0
__ Lehman College Foundation Scholarship

__ Bronx CUNY Scholarship

__ Bronx Dominican Parade Scholarship

__ St. George’s Society Scholarship

• Please note that a particular scholarship may require for you to submit a separate application and
additional documents such as essays, letter(s) of recommendation etc.

Biographical personal statement


________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Scholarship essay(s)

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Applicants must print name here

I hereby certify that all of the information in this scholarship request form is accurate and complete.
I understand that all the information contained in this form will be treated confidentially and will be
used for institutional purposes only. If awarded a scholarship, the organization may utilize this
information for academic purposes.

Applicant name ________________________________________ Date ____________________

For Office Use Only:

GPA: _________ Credits:_________

For further information please contact:


Scholarship Office
250 Bedford Park Blvd. West
Bronx, NY 10468
Shuster Hall room 205
718-960-8382
[email protected]

• This form should be submitted only once.

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