Student Financial Services

UNA General Endowed Scholarship Application

Complete ALL items below. Enter N/A if an item does not apply to you. APPLICATIONS MUST BE RECEIVED BY THE OFFICE OF STUDENT FINANCIAL SERVICES by February 1, 2013.

Personal Information:

Applicant Name (Last, First, MI) *

Permanent Home Street Address *

City *

State *

Zip *

Home Phone xxx-xxx-xxxx *

Email address *

High School Attended:

Name: *

Graduation Date: *

I received a: *
High School Diploma
GED

Overall HS GPA: *

ACT Composite Score *

SAT Verbal and Math: *

Academic Information:

Current Major(s): *

Minor(s): *

UNA Hours Completed: *

Transfer Hours: *

Miscellaneous Information:

Do you currently receive a scholarship from UNA? *
Yes
No

If Yes, please list the scholarship(s) you receive: *

Are either of your parents Alumni of UNA? *
Yes
No

If yes, please give the name(s) of parent(s): *

Are you or your parents members of Listerhill Credit Union? *
Yes
No

Mission Statement:

Briefly state your educational, career, and/or life goals. Please write using collegiate composition guidelines (including proper language, punctuation, capitalization, etc.). You may also attach a typed statement to this application. *

I affirm that all statements made in this application are true, to the best of my knowledge. If awarded an Endowed Scholarship, I will abide by the terms and conditions of the scholarship. Applications received after February 1, 2013 will not be considered. Signed: *

Date: *