SUNY EMPIRE STATE DIVERSITY HONORS SCHOLARSHIP
Spring 2020 Application
Name: ________________
______________________ M#: _____________________________________
Address: __________________________________________________________________________________
Street City State Zip Code
Telephone: (________) ____________________ Email: ____________________________________
If Freshman Student:
High School Final Average: _______
Year Graduated: ________________
High School Attended: _______________________
Location: ______________________________
If Continuing College Student:
Previous Semester GPA: _______
Dates Attended: ________________
College Attended: _______________________
Location: ______________________________
MVCC Information:
Major: ______________________________ (secondary, if any): _______________________________
Clubs/Activities: _____________________________________________________________________
Community Involvement: ______________________________________________________________
Diversity Indicator(s)/background you contribute to MVCC: __________________________________
____________________________________________________________________________________
Residency requirement: U. S. Citizen U. S. Permanent Resident
Are you a New York State resident? Yes or No
Please state your Short Term (next 3 years) personal/career goals: ____________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Please state your Long Term (beyond 3 years) personal/career goals: __________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Attach (please submit only complete applications):
Cop
y of High School or College transcript with GPA
Letter of recommendation
500 word essay on how you contribute to the diversity on campus
(For official use only)
Sig
nature: __________________________________________________ Date: _________________________
click to sign
signature
click to edit