NOSAFinancialSupportAwardScholarship

NOSA will award (1)$1000scholarshipawardto a 2017-2018NOSAmemberthatdemonstratesfinancialneed(NationalNOSAexecutivemembers are noteligible).

Criteria:

1.Is amemberofthe NationalOptometricAssociationStudentAssociation in the Unites States and Puerto Rico.

2.Is currentlya second(classof2016) orthirdyearstudent (class of2017)in goodacademicstandingathis/herrespectiveoptometricprogram(GPA2.50 or higher).

3.Demonstratesfinancialneed.

APPLICATION

Date

LastNameFirstNameMiddleInitial

CurrentAddress City, State, Zip PermanentAddress City, State, Zip TelephoneNumber Email DateofBirth

OptometricInstitutionGraduationClass NOSAAdvisor TelephoneNumber Applicant’sSignature Date

PartII

FINANCIALRESOURCES

Areyoufinanciallyindependent?(circleone)YesNo

Numberof dependents Relationship toapplicant Ifmarried,is spouse a student?_ _Fullor parttime? Spouse’soccupation

Spouse’sAnnualIncome (s) How do youfinanceyoureducational and personal expenses?

(Useseparatesheetifneeded)

Pleaselistthenames anddollaramountsoffinancialaidreceived. (Pleaseattach acopyof yourfinancialprofile,whichcan beobtainedfromyourfinancialaidofficer).

Loans:

Grants:

Scholarships:

FinancialAssistance(spouse,family):

Other (SocialSecurity,Veteransbenefits, childsupport):

Whatdo youanticipateyourannual expensesto bethisupcomingyear?Tuition$_

Housing $ Meals$ Equipment$ Books$Personal $

Medical $ Other (explain) $(Useseparatesheet ifneeded)

PARTIII

APPLICANT’SSTATEMENT:

Pleasesubmita onetotwopagetyped,double-spacedessayhighlighting

1)Yourreason(s) forapplyingfor thisaward

2)Yourcareergoals

3)Communityor collegeinvolvement

4)A statementasto theimpactyouhavehad inaffectingpositivechangethathasenhancedourminoritycommunities.(Pleasebe specific)

LETTERS OFRECOMMENDATION:

Pleasesubmittwo(2)letters ofrecommendationfroman educatorand/oradministrator.

OFFICIAL TRANSCRIPT

Pleasesubmitan official copyof yourtranscriptfromyour college ofoptometrytothe addressindicatedbelow.Pleasenoteifapplyingformultiple NOSAscholarships, onlyONEtranscriptisneededoverall.

FINANCIALPROFILE:

Pleasesubmita profilestatement,whichcan beobtainedfromthe financialaidofficeratyourinstitution.

ApplicationandTranscriptInstructions

1.Completeapplication,personalstatement,acquiredrecommendations,andfinancialprofile.

A.Scan electronic copyandemailto:

2.MailofficialTranscriptsOnlyto:

Valenta Carter,OD

NOAStudent Director

3501 Custer Pkwy Ste 105

Richardson, TX 75080

(NOTE:Applicationsandtranscriptsaremailedtoseparateaddresses)

1.TranscriptsandApplicationsmustbereceivedby:RECEIVED by May31, 2018

Therecipientofthisawardwillbeannouncedatthe NOSA Luncheon held during theNationalOptometricAssociationConvention,July 10th-15th in San Antonio, TX.