The Enpol Scholarship Application Form

The Enpol Scholarship Application Form

TODAY’S DATE: __________________________________

NAME: _______________________________________________________________

STUDENT #: _________________________ PHONE #: ________________________

UB E-MAIL: ____________________________________________________________

MAILING ADDRESS:____________________________________________________

_______________________________________________________________________

CITIZENSHIP (i.e. of what country are you a citizen?): _____________________________

DEGREE(S) AND MAJOR(S): (e.g. BA, double major in Linguistics and Spanish)

_______________________________________________________________________

_______________________________________________________________________

MINOR(S): _____________________________________________________________

YEAR IN SCHOOL : Sophomore Junior Senior

Other: _____________________________________________

EXPECTED DATE OF GRADUATION: _____________________________________

HAVE YOU RECEIVED FUNDS FROM CAS BEFORE, EITHER A SCHOLARSHIP OR STUDENT ASSISTANCE? If so, please indicate which fund, date(s), and amount of award.

______________________________________________________________________

______________________________________________________________________