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my
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Date
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List
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plete all secti
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Office of
J
ardine
H
1845 N.
F
W
ichita,
K
(316) 978
-
N
ame:
W
SU ID #:
Address:
m
anent Addre
s
C
itizen or Per
m
d
of Househo
l
s
, please prov
i
e
nt student cl
a
d
emic ma
j
or:
last enrolled:
e
cted WSU e
n
y
ou employed
m
e of employe
r
t
ion:
e
r Household
A
limon
y
$
D
isabilit
y
$
O
ther $
a
ll financial ai
d
oroptimis
o
ns of this fo
r
Financial
Ai
H
all Rm #20
3
F
airmount
K
S 67206-0
0
-
3430 or Toll
F
s
s:
m
anent Resi
d
l
d? Yes
i
de ages:
a
ssification?
n
rollment::
? Yes
r
:
Income:
d
and/or non
-
t Scholars
r
m legibly (ty
p
i
d/Scholars
h
3
24
F
ree 1-800-5
2
ent? Yes
No
Fre
s
Fall:
Year
No
C
J
D
-
institutional
s
hip Fund
Scholars
h
Dea
d
p
e or print if
n
h
ips
2
2-2978
First:
Date o
f
(If differen
t
No
s
hman
Hours
C
hild Support
ob Trainin
g
D
escribe:
s
cholarships
y
for Wichi
t
h
ip Appli
c
d
line: June
1
n
ecessary). A
t
Scholars
h
f
Birth:
t
)
D
Sopho
m
A
nticipa
t
Spring:
Numbe
r
$
$
y
ou are curre
n
t
a State U
n
c
ation
1
t
tach required
h
ip Qualificat
i
M
D
o you have
d
m
ore
Numb
e
t
ed graduatio
n
Year H
o
r
of hours per
M
n
tly applying f
o
n
iversity
S
information
a
i
ons: Financ
i
Degre
e
W
orki
n
Head
o
Other:
Phone #:
Phone #:
M
arital Status:
d
ependent chi
l
Junior
e
r of hours c
o
n
date:
S
u
o
urs
week:
Years o
M
onthly gross
Social Sec
u
Military
o
r or receivin
g
S
tudents
a
nd send pac
k
i
al Need (FA
F
e
Bound
n
g on 1st Bac
h
o
f Household
Female
Married
l
dren? Yes
Se
n
o
mpleted:
u
mmer:
Ye
a
f service:
wages: $
u
rit
y
$
$
g
:
k
et to:
F
SA)
h
elors
Male
Single
No
n
ior
a
rHours
Describe your academic and career goals: (attach additional sheet if necessary)
Describe your financial need for a scholarship: (attach additional sheet if necessary)
***INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED***
Required Items Checklist
Soroptimist Scholarship a
p
plication form
FAFSA (Free Application for Federal Student Aid)
must be on file with WSU for application year
Unofficial transcript
a
v
ailable on myWSU Portal (entire academic record)
Class schedule for application term
I certify that all answers I have given in the application are accurate to the best of my knowledge. I grant permission for
Soroptimist International of Wichita, Kansas, to obtain information regarding my academic standing, enrollment status, and
financial status in order to evaluate my candidacy for scholarship awards. I understand that this information will be kept strictly
confidential and will be available only to the scholarship committee members having a need to know for the purpose of
scholarship determination.
If I am awarded a scholarship from Soroptimist International of Wichita, Kansas, I authorize said organization to publish my
name as a scholarship recipient and understand that I may be asked to attend a Soroptimist function.
Signature of Applicant: ____________________________________________________ Date: ______________________
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, sexual orientation,
marital status, political affiliation, status as a veteran, genetic information 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 KS 67260-0205; telephone
(316) 978-6791.