ISU ID #:
College / School:
Funding Index:
Person Completing Form: Contact Number:
20
20
20
20
I hereby accept the scholarship under the above terms:
Signed:
Date:
Department Chairperson or Department Head Date
Dean, College or School
Date
Dean, College of Graduate and
Professional Studies
Date
Comments:
Spring
Summer I
Summer II
Funding Dept:
Year Term
Fall
I have verified that the student named above meets the eligibility requirements for a graduate student academic scholarship, and that the
funds are available for payment.
Hours Awarded
Approval Signatures
INDIANA STATE UNIVERSITY
TUITION FELLOWSHIP AND
SCHOLARSHIPS
Student Name:
Department:
Residency Status
GPA
Resident
Non-Resident
Admission Status: __________
Major: ___________________
Attempted Hours: ____
Degree: __________________
Principal Investigator, Grant (if applicable)
To be completed by Department
Date
Student Acknowledgement
This financial scholarship award covers a significant portion of the approved tuition and fees. The award does not include
mandatory student fees (such as recreation center fees). Additionally, all graduate student recipients will be responsible for a
modest fixed rate fee per credit hour that may vary annually based on approved tuition increases. In Fall 2010, the fee was set at
$50.00 per credit hour. This fee is indexed to tuition and will increase annually. Any unused portion of this award is
non-transferable. For eligiblity requirements, please refer to the Graduate Assistantship and Scholarship/Fee Waiver Award
Guidelines. The University may be required to report the amounts of this award to the Internal Revenue Service. Please be
aware that this award may impact other finance aid awards.
(Must accompany Graduate Assistantship Pay Authorization)
