Scholarship Application-Division of Social Sciences for Academic Year 2021-2022
Scholarship Application-Division of Social Sciences for Academic Year 2021-2022
Please Complete All Items on Page 1 - Scholarship Information Is on Page 2
Applications Must Be Submitted By/On March 29, 2021.
Return completed application to the Social Science Office (Science 200) or submit online (on Social Sciences Webpage)
Date
Date
/
MM
/
DD
YYYY
Name
Name
First
Last
ID Number
Maximum of
9
digits allowed.
Currently Entered:
3
digits.
Please enter your 774 number here.
Campus Box
Email
Street Address
Address Line 2 (If Applicable)
City
State / Province / Region
Postal / Zip Code
Maximum of
5
digits allowed.
Currently Entered:
0
digits.
Country
Preferred Contact Phone Number
Preferred Contact Phone Number
-
###
-
###
####
Major(s)
CU GPA:
Credit Hours Completed (do not include current semester):
Current Status
Current Status
Freshman
Sophomore
Junior
Senior
High School Attended:
Year of HS Graduation:
High School ACT/SAT (if required for scholarship):
WV Resident
WV Resident
Yes
No
Mercer County Resident
Mercer County Resident
Yes
No
Current Financial Aid: Type/Scholarship Name;Amount; Period of Award/Renewable
1. 2. 3. 4.
I am applying for the below checked Division of Social Sciences scholarships:
I am applying for the below checked Division of Social Sciences scholarships:
Lewis E. Tierney Scholarship
Undergraduate Waiver (CCUS)
Joseph Hatcher Scholarship
I hereby affirm that all of the information on this application is true and correct to the best of my knowledge and belief. I understand that I must be a full-time student during the semesters for which I am awarded a scholarship. I understand that all scholarships awarded for consecutive semesters may be forfeited if I fail to comply with the criteria as set for in this application.
Typed Name:
Date
Date
/
MM
/
DD
YYYY