! ! Rev.!4/12!
Osher Reentry Scholarship Program Application – Part 1
Scholarship is for non-traditional returning adult students who are seeking their first bachelor’s degree have experienced a cumulative gap in your education of at
least five years, are a newly admitted WSU student pursuing your first
bachelor’s degree, can demonstrate financial need (applicants must complete and file a FAFSA and
submit the results via the SAR), can illustrate potential for academic success by maintaining at least a 2.5 cumulative GPA in all coursework. Will show academic
promise and commitment to obtaining a degree. Preference given to students aged 25-50.
First Semester of Enrollment (circle one): Fall 20___ Spring 20___ Summer 20___
Expected Enrollment (credit hours): Fall: _____ hrs Spring: _____ hrs Summer: _____ hrs
SECTION 1. APPLICATION INFORMATION
myWSU ID#
Legal Last Name First Name MI
Date of Birth
Mailing Address City ST Zip Code County
Permanent Address (if different from mailing address)
Phone Number (including area code) Email addr
ess
High Schoo
l Graduation Date (mm/yyyy)
College Last Attended (if applicable) Last Term of Attendance
Have you previously attended WSU? Dates of Attendance _________________________________________________________________
Do you have a Bachelor’s Degree?
yes no
Are you a U.S. citizen or permanent resident? yes no
Does your employer offer tuition assistance?
yes no
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED
Complete applications require:
• Completion of application form [part 1]
• Full admission to WSU, including official transcripts, on file with the Office of Admissions
• A copy of your current resume
• Student Aid Report (SAR) - please print and attach to this application
• An essay addressing the three questions listed on the second page of this application. [part 2]
_____________________________________ _________________________________
Signature Date
Student Certification and Submission: By completing and submitting this application for review, I certify that all the answers I have given in this application are correct to
the best of my knowledge. I understand that failing to disclose or falsifying information could result in my dismissal from Wichita State University and that making false
writing is a felony under Kansas law (K.S.A. 21-3711). Social Security number and student status data may be provided to other state agencies for use in detection of
fraudulent or illegal claims against state moneys. I grant permission to obtain information about my grade point average, enrollment status and financial status to evaluate my
candidacy for scholarship awards. I understand this information will be kept confidential and will be available only to Scholarship Committee members having a need to know
for the purpose of scholarship determination. If I am awarded a scholarship, I authorize Wichita State University to publish my name as a scholarship recipient.
Notice of Nondiscrimination: Wichita State University does not discriminate in its programs and activities on the basis of race, religion, color, national origin, gender, age, marital status, sexual orientation, status as a veteran or
disability. The following person has been designated to handle inquiries regarding nondiscrimination policies: Director, Office of Equal Employment Opportunity, Wichita State University, 1845 Fairmount, Wichita, Kansas 67260-
0145, (316) 978-3001.
