Lucas-Hathaway Scholarship Application

Lucas-Hathaway Scholarship Application
Name of student:
E-mail:
Box:
Date:
Term of study:
Internship:
Where:
Roanoke College supervisor:
On-site supervisor:
Independent study: (preapproval of independent study required)
Roanoke College supervisor:
Study abroad:
Destination:
Courses:
Conference:
Name of conference:
Destination:
Dates of travel:
Mode of transportation:
Roanoke College supervisor:
Amount requested:
Explanation of how funds are to be used:
Student signature
Faculty Supervisor signature
Return form to: Chair, Public Affairs for approval. Requests should be submitted 30 days prior to the start of the project.
Denied: ______Approved: ______Amount: ______
Chair signature: Date: