2012-2013 Student Scholarship Application Cover Sheet SCHOOL OF CRIMINAL JUSTICE Deadline: February 1, 2012 LAR Dean’s Office: LAR 104 Please Use this as your coversheet for each application submitted. NAME (Last, First, Middle):_______________________________________________ STUDENT ID: __________________________________________________________  Judge William and Lucille Myers Scholarship  The Sid Brown Excellence in Criminal Justice Research Award Please attach this coversheet to your entire application packet and return to: LA Dean’s Office. Liberal Arts Building, Suite 104 Attn: Terri Winblad, scholarship coordinator, X5567 2012-2013 Student Scholarship Application University of Central Oklahoma - College of Liberal Arts Deadline: February 1, 2012 Return to: College of Liberal Arts Dean's Office, LAR 104 Personal Information: Last Name First Name Middle Initial Current Address Banner ID UCO E‐mail Phone City, State, ZIP Year in College  Freshman  Sophomore  Junior  Senior  Graduate Student Current Status: Number of College Hours Completed Cumulative GPA  Full‐time  Part‐Time Major Minor Expected Graduation Date Parents Names Parents City of Residence Hometown Newspaper Please list UCO honors and organizations and summarize any extracurricular and community activities: Describe any financial needs you may have: What are your career goals after graduation? ATTACHMENTS  Personal Statement (if required) Please limit your response to 200 words and attach to application as required for scholarship.  Letter(s) of Referral (if required)  Writing Sample (if required)  Official current transcript (available from transcript kiosk, located in the Nigh University Center)  Resume If you are selected as a scholarship recipient, do you agree to allow your name and biographical information to be released to the scholarship donor and to be used in any campus or public publication? Yes No I understand that furnishing false information may result in revocation of any scholarship received or may result in disciplinary action pursuant to the University of Central Oklahoma Code of Student Conduct. Signature Date