2019-2020
Department of Physical Science Scholarships
Application Deadline: March 1, 2019
1. CATEGORYIndicate below your class status for the upcoming academic year:
Freshman Sophomore Junior Senior
2. PERSON
AL DATA
Name (First Ml Last)
US Citizen?
Yes No
Perm. US Resident?
Yes No
Citizenship, if not US?
T#
Alien Registration No. (If applicable)
Permanent Mailing Address
Address at School
City
State
Zip
City
State
Zip
Phone
Preferred Email address
If a scholarship is awarded, which address would you like your offer letter to be
mailed to: Permanent Mailing Address Address at School
3. EDUCAT
ION
High School Name High School Location (City, State) Year Graduated
Current Declared Major at SUU:
Major Concentration (i.e. Healthcare,
Professional, Teaching, etc.)
Other College or University Attended (If applicable)
Location (
City & State)
College GPA (Include basis, e.g. 3.5 out of 4.0)
out of
Major Subject: Degree: Year:
Degree Expected: Year:
Other GPA (Include basis, e.g. 3.5 out of 4.0)
out of
Department of Physical Science scholarships can be applied to tuition only. Do you anticipate receiving and accepting any new/continuing scholarships awarded by SUU (i.e.
President's, Founder's, Dean's, Centurium, GHA, Sterling, Non Resident, etc.) that could affect the eligible scholarship amount you receive from the Department?
No Yes If you answered yes, please indicate Scholarship Name and anticipated amount:
What are your anticipated plans after graduation from SUU? (i.e. Medical School, Pharmacy School, Graduate School, Teaching, Work in Field, etc.)
SUBMIT
ONLY ONE APPLICATION. YOU WILL BE CONSIDERED FOR ALL SCHOLARSHIPS FOR WHICH YOU QUALIFY.
ELIGIBILITYTo be eligible, an applicant must satisfy the following requirements
1. Must be a full time student at Southern Utah University (12 or more credits each semester).
2. Must be a declared major in one of the degrees offered by the department of physical science or be a declared major in the field specified by
specific
scholarship donors.
3. Is not receiving full funding for education from another organization (e.g. students receiving full reimbursement from an employer).
ALL AP
PLICANTS
APPLICATION FORM
STATEMENT OF ACTIVITIES, HONORS, LEADERSHIP LIST not an essay school and community activities, including years in which you
participated. High school activities may be included if you are currently a high school or freshman student. Identify leadership positions you have held. List
any honors or awards you have received.
PROFESSIONAL DATA – Supply a brief resume of any work experience, including your duties, starting and terminating dates, salary and any other
pertinent information. Briefly describe any research projects, design projects or design teams in which you have participated.
INTERESTS & HOBBIES –Briefly describe any special interests, hobbies, sport or musical accomplishments.
APPLICANT’S STATEMENT A statement or essay written by the applicant, NO MORE THAN ONE SINGLE-SIDED DUBLE-SPACED TYPEWRITTEN
PAGE, telling
a) why you would like to be a physical science major (e.g. chemist, geologist, etc.)
b) how you believe you will make a difference as a physical science major (e.g. chemist, geologist, etc.)
c) what influenced you to study physical science (e.g. chemistry, geology)
d) what you anticipate your future plans/goals to be
ST
ATEMENT OF ACTIVITIES, HONORS, LEADERSHIP - List school and community activities, including years in which you participated. High
school activities may be included if you are currently a high school or freshman student. Identify leadership positions you have held. List any
honors or awards you have received.
DATES
ACTIVITY
PR
OFESSIONAL DATA Supply a brief resume of any work experience, including your duties, starting and terminating dates, salary and any
other pertinent information. Briefly describe any research projects, design projects or design teams in which you have participated.
Dates
Salary
Employer/Description of Duties
INTERESTS & HOBBIESBriefly describe any special interests, hobbies, sport or musical accomplishments.
APPLICANT”S STATEMENT A statement or essay written by the applicant, NO MORE THAN ONE
SINGLE-SIDED DOUBLE-SPACED TYPEWRITTEN PAGE, telling
why you would like to be a physical science major (e.g. chemist, geologist, etc.)
how you believe you will make a difference as a physical science major (e.g. chemist, geologist, etc.), what are your career
goals
what influenced you to study physical science (e.g. chemistry, geology)
what you anticipate your future plans/goals will be