Fillable 2021-2022 APPLICATION FOR SCHOLARSHIPS (Virginia State University)

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2021-2022 APPLICATION FOR SCHOLARSHIPS (Virginia State University)

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Office of Student Financial Aid
P.O. Box 9031
Virginia State University, VA 23806
APPLICATION FOR SCHOLARSHIPS
This application is for a merit-based scholarship award from Virginia State University only. All information
provided must be current. Students must also complete the Free Application for Federal Student Aid (FAFSA). The
student must have a cumulative GPA of 3.00 and be enrolled full-time to receive this University scholarship.
Incomplete applications will not be processed. (Deadline to submit Merit-Based Scholarship Application is April
30, 2021).
Scholarship Type: University Other ____________________________________
Name: _______________________________ SS # (Last 4 Digits): __________ V#________________
Local Address: _______________________________________________________________________
Permanent Address: ____________________________________________________________________
Email address: _____________________________ Local or Cell Phone #: ________________________
Date of Birth (Month/Day/Year):___________________ Sex: Male Female
Marital Status: Single Married Separated Divorced Number of Dependent (s) ______
Citizenship U.S. Alien Registration # ____________________
Other __________________
Indicate your enrollment status: Full-time (12 hrs. or more) Part-time (11 hrs. or less)
Classification: Freshman Sophomore Junior Senior
Major: _________________________________ Department: _________________________________
Provide a Departmental reference:
Name: _____________________ Department: ______________________ Telephone#______________
I understand that submitting this application does not guarantee a scholarship. Receiving this scholarship is
contingent on funding availability. I certify that the information provided is true.
_____________________________________________________________________________________
Signature Date
For Office Use Only
2021-2022 Award Period
Budget _____________________
Award _____________________
Remaining Need _______________
EFC # ___________ PELL AWARD ____________
Academics
Cum GPA ___________
Major________________________________
Classification _________________________
Reviewed By: __________________ Date: _____________
2021-2022
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2021-2022 APPLICATION FOR SCHOLARSHIPS (Virginia State University)

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Completed 3 August 2021

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