9201 University City Boulevard, 230 Fretwell, Charlotte, N.C. 28223-0001

Office of Disability Services

Tel: (704) 687-0040 (V/TTY) Fax: (704) 687-1395

SCHOLARSHIP PROGRAMS

*Completed Applications Due: March 20, 2015 by 5:00 pm

Scholarships Available through the Office of Disability Services

There are multiplefinancial need-based scholarships available through Disability Services.Scholarships are awarded through various funds, includingFriends of Disability Services, Carol Douglas Scholarship, Kristian Champion/Jeremy Lewis Scholarship, and the Lions of the Piedmont Endowment Fund. The minimum scholarship award is $1,000.

EligibilityRequirements

Have a documented disability and be registered with Disability Services
Be a legal resident of the United States or possess a valid student visa
Have documented financial need
Be a current and ongoing undergraduate enrolled at UNC Charlotte
Have a minimum of 6 credit hours and remain enrolled during both semesters of the award year
Have a minimum cumulative GPA of 2.5at UNC Charlotte
Have no disciplinary actions on academic record
Sign aConsent to Release Student Information

Scholarship Award

Completed applications are due in the Office of Disability Services by5:00 pm on March 20, 2015. A Scholarship Selection Committee will decide which students are given awards. Recipients will be notified via emailby mid-May. Recipients will also receive an award letter, which will be sent to the address provided on the application. The scholarship money will be awarded for the following academic year, divided between the fall and spring semesters.The student must remain enrolled both semesters of the award year. Scholarships are not renewable, but students may reapply for scholarships each year.

SCHOLARSHIP APPLICATION CHECKLIST

______FAFSA, Financial Aid Reward Letter, and Student Aid Report (SAR)

______Release of Information (included in this packet)

______Application Form (included in this packet)

______Personal Statement/ Essay (guidelines are included in this packet)

______Resume

______Transcript (unofficial)

______Two Professional References (request included in this packet)

Disability Services Scholarship Application Information

To apply for a scholarship available through Disability Services, complete the application that is included in this packet, write a personal essay (see criteria below), provide two professional references,submit your financial need documentation, UNC Charlotte transcript, resume, and a signed release allowing your information to be shared. All information is due in the Office of Disability Services by March 20, 2015 by 5:00 pm. Late and incomplete applications will not be accepted!

Financial need documentation

Complete a current year Federal Application for Free Student Aid (FAFSA) in order to receive a Student Aid Report (SAR). Provide the SAR and a copy of your Financial Aid Reward letter (available in BANNER).

UNC Charlotte transcript

Your unofficial transcript can be obtained through BANNER. Print a copy and attach to the application.

Personal Statement/Essay

Write and attach a personal essay of 500 words or less. Please include the following information:

Describe how your disability has impacted your life and its effect on you in the academic setting.
Explain why you would benefit financially by receiving this scholarship. Please address any specific financial needs that may not be met otherwise.
Provide any additional information regarding your ambitions, goals, leadership roles, community service, and any other factors you would like to be considered during the selection process.
If applying for the Kristian Champion/Jeremy Lewis Scholarship- respond to these additional questions on a separate document. What is the biggest misconception others have about you? How can you educate others about their misconception?

Resume

You can get help writing your resumefrom The University Career Center, Atkins 150, 704-687-0795,

Two Professional References

Provide a professional reference from two individuals.Each reference form must be in a sealed envelope with the reference’s signature over the flap.

Judging Criteria

The Scholarship Selection Committee will use all of the information provided in the application to identify the students most qualified. All components of the application are relevant.

Completed applications are due in the Office of Disability Services by March 20. 2015by5:00 pm. If mailing the application packet, allow sufficient time for delivery to arrive by March 20th. Applications can be turned in at the Disability Services front desk.

UNC Charlotte

230 Fretwell Building

9201 University City Boulevard

Charlotte, NC 28223

SCHOLARSHIP APPLICATION

Date: ______Student ID #__800______

Name: ______

Address:______

______

Cell/Home Phone Number: ______

University E-Mail Address: ______

College/Major: ______Cumulative GPA: ______Hours Complete:______

Current classification: □Freshman □Sophomore □Junior □Senior

Is the nature of your disability physical? □ Yes□No

If yes, have you had it since birth? □ Yes□No

Career Goal: ______

______

Awards and Honors (attach list if necessary): ______

______

Community Service (attach list if necessary): ______

______

Professional Reference Form

Applicant Name: ______

Reference Name: ______Position: ______

Length of time you have known the applicant: ______

Capacity in which you have known the applicant: ______

The above named individual is applying for a scholarship through the Office of Disability Services. Please rate the applicant in the following areas and provide any information you feel is relevant. You may attach an additional sheet, if needed. Please return this form and any attached documents to the applicant in an envelope with your signature over the sealed closure.

Outstanding / Above Average / Average / Below Average / Not Observed
Judgment
Makes decisions objectively, confidently, and wisely
Service to the Community
Actively contributes to improving the community
Ethical Conduct
Functions on the basis of accepted ethical standards
Dependability
Follows through on commitments
Self-Confidence
Carries out actions with assuredness
Motivation
Highly determined to accomplish tasks and goals
Initiative
Takes action proactively
Academic Potential
Potential to succeed in an academic environment

Additional Comments:

Professional Reference Form

Applicant Name: ______

Reference Name: ______Position: ______

Length of time you have known the applicant: ______

Capacity in which you have known the applicant: ______

Additional Comments:

Office of Disability Services

9201 University City Boulevard, 230 Fretwell, Charlotte, N.C. 28223-0001

Tel: (704) 687-0040 (V/TTY) Fax: (704) 687-1395

CONSENT TO RELEASE INFORMATION

I authorize the Office of Disability Services at UNC Charlotte to release specific information from the application of(your name)______to the Scholarship Selection Committee. This information will remain confidential among committee members and will include the following: financial information, academic records, work history, and personal references. Information regarding your type of disability will be shared with the selection committees that have specific disability requirements. The endowment funding organizations will also be notified of the scholarship award recipients.

I further recognize that as a result of my association with the Office of Disability Services scholarship program, my status as a registered student with a disability will be disclosed through my scholarship award. The Office of Disability Services will not disclose disability specific information about award winners.

This information is being provided as part of the Disability Services Scholarship selection process. My consent is voluntary, and I realize that I may revoke this consent at any time except to the extent of information that has already been released.

______800______

Applicant’s Name (Printed)Student ID #

______

Applicant’s SignatureDate

Disability Services Scholarship 2015