Full Legal Name (as it appears on your passport)
_______________________________ _____________________________________________________
Family or Surname First or Given Name
Mailing Address
_______________________________________ ___________________________ ___________________
Street Address or Post Office Box Number City State/Province
________________ _____________________________
Postal Code Country
_________________________________________
Telephone Number – include country code
_________________________________________
E-mail Address
GPA / Test Score Information
High School Grade Point Average/Percentage: _________________
Accuplacer Score: ___________________
Accuplacer Test Date: __________________
Scholarships will be awarded competitively to students who are currently enrolled full-time in the English Language Institute at Arkansas
Tech University with admission status to the university. The scholarship requires a minimum 3.25 cumulative high school GPA and a
minimum of 246 Accuplacer composite score. The scholarship application, final official high school transcript, and Accuplacer scores
must be received in the Office of International Admissions by May 15 for the fall semester or December 15 for the spring semester. All
scholarship recipients must be admitted to the university and enroll in a minimum of 15 main-campus hours before the scholarship will
be authorized. Unless an exemption to the residency requirements is received from the Residence Life Office, all scholarship recipients
must live on campus. Academic scholarships must be used on the main campus in Russellville. Renewal requirements will be included
in the scholarship offer letter and are available on our website at www.atu.edu/imsso. Students receiving scholar awards must hold valid
nonimmigrant visas. Depending on the country of origin, this scholarship may be taxable. To remain in compliance with Act 323 of
2009, the University reserves the right to cancel or modify any scholarship funded by the institution at any time.
I certify that the above information is true and correct to the best of my knowledge. I have read and understand the information on this
application and the renewal requirements for the scholarship which I am applying.
Applicant’s Signature_______________________________________ Date ______________
Scholarship applications submitted without your signature and/or support of all required documents will be
regarded as incomplete and will not be considered for an award.
APPLICATION FOR ELI GRADUATING SCHOLARSHIP
International Admissions, 105 West O Street, Brown Hall, Suite 104, Russellville AR 72801
click to sign
signature
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