Please complete the application
below. IMPORTANT: February 15, 2010 is
the application deadline for Development Foundation
scholarships. Although answering any item on this form is
optional, you will be considered for every available award any
if all questions are completed.
Scholarship eligibility requires:
Application for admission to a degree program.
High school transcript or G.E.D. score.
ACT/SAT Scores
College transcripts (if applicable).
Completion of the Free Application for
Federal Student Aid (FAFSA) with EFC number by February 15, 2009 for need-based
scholarships.
Name:
Last
First
M.I.
Maiden
SSU ID #
U.S. Citizen:
Gender:
Male Female
List honors, awards, recognitions received:
List high school/college activities, clubs:
Specifically describe extent of
involvement in community activities and
organizations:
Indicate length of time involved in
community activities and organizations :
Briefly describe your career goal:
Scholarship Specific Information: Please check the
following scholarship-specific information if it applies to you.
Son/daughter of a Scioto County firefighter, police officer, state
trooper, or sheriff deputy. (Submit proof with
application)*
Mobility Impaired (Requiring use of wheelchair)
American Savings Bank employee or child/grandchild of employee
Name of Employee:
Mitchellace employee or child/grandchild of employee
Name of Employee:
USEC employee or
immediate family member of employee
Name of Employee:
Big Sandy
Superstore employee or child of employee
Child or grandchild of Vietnam-era veteran (Submit DD214
of relative with application)*
Working full time while attending Shawnee State University
Scioto County, Ohio4-H Member (Submit copy of
membership card with application)*
From Single Parent Home
Smoker
Member of
Shawnee State Honors Program
Prior Bachelor's degree
Maintained a 3.0 GPA in Foreign Language or Linguistics courses
Graduate of
Scioto County Joint Vocational School by June, 2010 (For Freshman Only)
Attended & graduated from New Boston School District Number of
Years:
Attended & graduated from Washington Local
School District Number of Years:
SSU Men's or Women's Basketball Player
(Have coach sign scholarship signature form below)
Shawnee State senior whose athletic
eligibility is exhausted (Have coach sign scholarship signature form below)
Two East High School (Sciotoville) sports letters (List sports. Have coach sign
scholarship signature form
below)
List Sports:
Check here to apply for the Barnes and Noble Textbook
Scholarship.
*Important: If proof of
membership or employment is not returned with scholarship
application, student will not be considered for that particular
scholarship.
Attached Forms
Students needing to submit
athletic coach signatures with their applications need to print the
attached "Scholarship Signature Form"
and mail or fax it to our office by February 15, 2010 to be considered for the appropriate
scholarships. If you do not need athletic coach signatures, you may submit
this form using the Submit Form button at the bottom of this form.
I have read the above form and completed all of the
necessary information:
By Submitting this application you give permission to the SSU Financial Aid
Office to release financial and academic information to prospective donors
as needed.
I
certify that the information given above is complete and
accurate. I understand that I may lose or be required to repay funds that I receive if
information, which affects financial aid award amounts, is omitted or inaccurate.
