Rts Application
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Beta Theta Pi Scholarship Application
Submit Application to:
by October 23, 2004
Please complete the following information. By applying for this scholarship you are not committing yourself to membership in Beta Theta Pi or any other organization. The scholarships will be awarded at an invitation only reception. First Name
Middle Name
Permanent Address
City
State/Prov.
Last Name
Campus Address
Zip/P.C.
City
State/Prov. Zip/P.C.
Permanent Phone
Campus Phone
Email address
Transfer Student: Yes
Date of Birth
High School
Major_______________________
Class Rank
No
H.S.GPA College GPA
Current Year: Fr. Soph. Jun. Sen.
1
Honors, Achievements, Awards________________________________________________ ________________________________________________________________________
2
Community Service/Extracurricular Activities__________________________________ _________________________________________________________________________
3
Please describe yourself in one sentence_________________________________________ __________________________________________________________________________ Please attach any additional information you think would be pertinent to your application. You are encouraged to submit a resume if you so wish. Applicant’s Signature
Date
Submit Application to:
by October 23, 2004
Please complete the following information. By applying for this scholarship you are not committing yourself to membership in Beta Theta Pi or any other organization. The scholarships will be awarded at an invitation only reception. First Name
Middle Name
Permanent Address
City
State/Prov.
Last Name
Campus Address
Zip/P.C.
City
State/Prov. Zip/P.C.
Permanent Phone
Campus Phone
Email address
Transfer Student: Yes
Date of Birth
High School
Major_______________________
Class Rank
No
H.S.GPA College GPA
Current Year: Fr. Soph. Jun. Sen.
1
Honors, Achievements, Awards________________________________________________ ________________________________________________________________________
2
Community Service/Extracurricular Activities__________________________________ _________________________________________________________________________
3
Please describe yourself in one sentence_________________________________________ __________________________________________________________________________ Please attach any additional information you think would be pertinent to your application. You are encouraged to submit a resume if you so wish. Applicant’s Signature
Date
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