Please return form to Mrs. Barbara Knight, Walters 109. Questions, please call 662-846-4240.
For division use only. Date received ___________________________
Division of Mathematics and Sciences Academic Awards & Scholarships Application Form
Application must be received by 12:00pm, Friday, Feb. 28, 2020. No late applications will be accepted.
To be considered, applicant must have completed at minimum one semester at Delta State University and
ALL requested information must be provided. Applications missing any required information will not be
considered. Please type or print legibly.
Name: ______________________________________________ DSU ID: ____________________
Major/concentration program: _________________________________________________________
(biology/pre-med, environmental science, chemistry/ACS, mathematics, etc.)
Advisor:_______________________________________ Current GPA: _____________
Current Classification: Freshman Sophomore Junior Senior
Expected graduation date: ________________
Current & expected level of funding/financial aid: (THIS SECTION MUST BE COMPLETED)
Current: 2019-2020:
Expected: 2020-2021:
In the space below, please share your future career plans and your qualifications for receiving a
departmental scholarship or award.
Signature _____________________________________________________ Date__________
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