SAVANNAH STATE UNIVERSITY
SCHOLARSHIP APPLICATION
APPLICATION DEADLINE - DECEMBER 31ST INSTRUCTIONS: (Please TYPE or PRINT)
(Example: December 31, 2009 for 2010-2011) Fill out the application completely and return to:
SAVANNAH STATE UNIVERSITY
SCHOLARSHIP COMMITTEE
3219 COLLEGE STREET
BOX 20523
PERSONAL INFORMATION SAVANNAH, GA 31404
SSU ID# or last 4 digits of SSN: GA Resident: ( ) Yes ( ) No
Name:
(Last) (First) (MI)
Phone#:( ) Email Address:
Permanent Address:
(Street)
(City) (State) (Zip)
Current Mailing Address (If Different):
(City) (State) (Zip)
SCHOLARSHIPS APPLYING FOR (2 maximum)
1- and 2-
ACADEMIC INFORMATION
Classification: ( ) Entering Freshman ( ) Returning Freshman ( ) Sophomore ( ) Junior ( ) Senior
(1-30 earned hrs) (31-60 earned hrs) (61-90 earned hrs) (91+ earned hrs)
( ) Transfer
MAJOR
COLLEGE/UNIVERSITY INFORMATION
Total accumulated hours: Previous quarter/semester hours & GPA:
**Submit official college transcript (Transfers only)
HIGH SCHOOL INFORMATION
Name & Address of School:
(City) (State) (Zip)
Graduation Date: Cumulative GPA: SAT: ACT:
**Submit official high school transcript. If SAT/ACT score is not included on transcript, submit an official document containing your score.
AUTOBIOGRAPHICAL SKETCH
(1) Please list your community service, extracurricular activities, awards, honors, leadership experience or any other significant commitments such as employment and/or hobbies.
(2) On a separate sheet of paper, please provide a personal statement highlighting any exceptional skills, talents and/or abilities (including the items listed at number 1) that you will bring to the university. Also include your future plans.
RECOMMENDATION SECTION (This section must be completed by a school official for award consideration)
In addition to the signature below, you must provide two separate letters of recommendation from a teacher, employer, or adult (non-relative) who knows you well.
( ) I highly recommend this student. ( ) I recommend, with reservation, this student.
( ) I recommend this student. ( ) I do not recommend this student.
( ) I am unable to recommend or not recommend this student.
Institution:
Name (please print): Title:
Signature: Date:
Telephone Number:( )
STUDENT SIGNATURE
I, hereby give permission to Savannah State University to share this information for the purpose of review and public relations. If necessary, I also authorize the release of all transcripts and test scores to Savannah State University. If it is determined that I have offered erroneous information, I may be required to repay all scholarships awarded based on this information or forfeit any remaining scholarship funds.
Signature Date
Scholarship Committee Use Only