Schola Pp Fr Trans 09
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Southern Illinois University Carbondale
Scholarship Application for Freshmen and Transfer MCMA Students Please type or print in black ink and return to your Academic Advisor. Due: January 30, 2009.
Student Information Name Student 850 # if known or full middle name Permanent/Home Address (street address, city, state, zip) Local Address (street address, city, state, zip) Phone #
Permanent/Home: Local / cell:
County E-mail address
Academic Record In Fall 2009 I will be a (circle)
Freshman Credits: (0-25)
Soph. Jr. Sr. (26-55) (56-85) (86+)
ACT or SAT score High School GPA or Transfer GPA Major & Specialization (check one): MCMA Undecided Cinema & Photography: Cinema Photography Journalism: Advertising/IMC News/Editorial Photojournalism Radio-Television: News Sales/Management Audio Production Video Production
1
Academic awards and accomplishments:
Leadership Activities List all co-curricular activities. Include the number of years you participated and the offices you held or awards you received. Please be sure to include all activities, especially those related to your major, such as competitions, conferences, or festivals in which you participated. Years in Activity Offices Held/Awards Activity
Work Experience and Career Goals List any jobs, paid or volunteer, you have had in the past three years, including part-time, student work, internships, community service, etc. Position Years City Employer
Describe your career plans as specifically as possible:
2
Financial Need Supplement Dollar amount of school paid by parents or other source. Family Income (approx. figure) Number of children in college Employment you now have or plan to have to help with finances
$
Salary (per month)
$
$________________/year
/month
Outline any special financial needs in detail.
Applicant Agreement In connection with this application, I grant members of the faculty and staff of the College of Mass Communication and Media Arts permission to review my personal and academic records. My waiver of legal privacy extends only to those reviews necessary and proper in connection with the consideration of my scholarship application. I hereby attest as the recipient of a scholarship, I authorize an appropriate news releases, including to the following newspaper: Newspaper name and address: ________________________________________________________________
Your signature: ______________________________________________ Date: _____________________
3
Scholarship Application for Freshmen and Transfer MCMA Students Please type or print in black ink and return to your Academic Advisor. Due: January 30, 2009.
Student Information Name Student 850 # if known or full middle name Permanent/Home Address (street address, city, state, zip) Local Address (street address, city, state, zip) Phone #
Permanent/Home: Local / cell:
County E-mail address
Academic Record In Fall 2009 I will be a (circle)
Freshman Credits: (0-25)
Soph. Jr. Sr. (26-55) (56-85) (86+)
ACT or SAT score High School GPA or Transfer GPA Major & Specialization (check one): MCMA Undecided Cinema & Photography: Cinema Photography Journalism: Advertising/IMC News/Editorial Photojournalism Radio-Television: News Sales/Management Audio Production Video Production
1
Academic awards and accomplishments:
Leadership Activities List all co-curricular activities. Include the number of years you participated and the offices you held or awards you received. Please be sure to include all activities, especially those related to your major, such as competitions, conferences, or festivals in which you participated. Years in Activity Offices Held/Awards Activity
Work Experience and Career Goals List any jobs, paid or volunteer, you have had in the past three years, including part-time, student work, internships, community service, etc. Position Years City Employer
Describe your career plans as specifically as possible:
2
Financial Need Supplement Dollar amount of school paid by parents or other source. Family Income (approx. figure) Number of children in college Employment you now have or plan to have to help with finances
$
Salary (per month)
$
$________________/year
/month
Outline any special financial needs in detail.
Applicant Agreement In connection with this application, I grant members of the faculty and staff of the College of Mass Communication and Media Arts permission to review my personal and academic records. My waiver of legal privacy extends only to those reviews necessary and proper in connection with the consideration of my scholarship application. I hereby attest as the recipient of a scholarship, I authorize an appropriate news releases, including to the following newspaper: Newspaper name and address: ________________________________________________________________
Your signature: ______________________________________________ Date: _____________________
3
