Full Legal Name (as it appears on your passport)
_______________________________ _____________________________________________________
Family or Surname First or Given Name
Permanent Home Address (in your home country)
_______________________________________ ___________________________ ___________________
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: _________________
IELTS / TOEFL / Eiken Score: ___________________
ACT / SAT Composite Score (Optional): __________________
Scholarships will be awarded competitively to students with a minimum 3.25 cumulative high school GPA and who have
been granted admission or early admission. The scholarship application and all supporting documentation must be received
in the Office of International Admission by March 31 for the fall semester or September 30 for the spring semester. All
scholarship recipients must be admitted to the university and must 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 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 INTERNATIONAL EXCELLENCE SCHOLARSHIP
/ INTERNATIONAL BACCALAUREATE SCHOLARSHIP
International Admissions, 105 West O Street, Brown Hall, Suite 104, Russellville AR 72801
click to sign
signature
click to edit
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