NORWICH UNIVERSITY SCHOLARSHIP APPLICATION

2016-2017 ACADEMIC YEAR

THE NORWICH UNIVERSITY

FRATERNITY SCHOLARSHIPS

·  Scholarships are open to all students who can document lineage to a fraternity member of one of the four fraternities: Sigma Alpha Epsilon, Sigma Nu, Sigma Phi Epsilon, and Theta Chi

·  Submit completed applications to Chrissie Eastman,

PERSONAL INFORMATION:

Name of Applicant: ID: (A#)
Home Address:
City, State and Zip:
Home Phone Number:
Campus Mailbox: Campus/Local Phone Number:
Class Year: Cell Phone: email:
Academic Major:

Family member(s) who were past members of one of the Norwich Fraternities:

Sigma Alpha Epsilon, Sigma Nu, Sigma Phi Epsilon, and Theta Chi

Name / Relationship / Class Year

Please list and give a brief description of additional documents you are submitting which helps us to determine you are a lineal descendent of the individuals listed above.

Please note that if you are chosen as a recipient for this scholarship, your name and brief biographical information will be published. This is to ensure that all fraternity members are made aware of the chosen recipient(s).

Signature: ______Date: ______