Brigham City Scholarship Utah State University Brigham City Regional Campus Summer 2015 Description: This scholarship has been funded by faculty, staff and friends of USU Brigham City Regional Campus for the purpose of helping deserving students fund their educational goals at USU Brigham City. Scholarship amount: Five $500. Scholarships will be awarded. Submission Date: Applications will be accepted until 5:00 pm on Monday March 16, 2015 Eligibility for scholarship: - US citizen - Must be admitted to Utah State University - Declared major of one of the bachelor degrees offered through USU Brigham City Regional Campus. - Will be a junior or senior (60 or more credits) beginning summer 2015. - Overall GPA of 2.75 or higher. The GPA posted after fall semester 2014 will be used to determine overall GPA. Criteria for Maintaining Scholarship: - The scholarship is for summer semester 2015. Funds cannot be used in any other semester. - Must be enrolled for a minimum of 6 credit hours during the scholarship period - Must be enrolled in Brigham City sections of classes only - Cannot be used with any other USU Brigham City Regional Campus sponsored financial award. - Not redeemable for cash. Application Procedure - Complete the Brigham City Scholarship application form. - Attach your typed Goal Statement. - Deliver your application documents to the Cashier Office, room 170, Milton P. Miller Building, USU Brigham City, or mail to Utah State University Brigham City Regional Campus Scholarship Committee 265 West 1100 South Brigham City, UT 84302 Incomplete application packets will not be considered. Acceptance Procedure Recipients of the scholarship will be notified by the email address provided on their application. - Recipient must return the Acceptance Agreement to the Cashier Office by Friday, March 27, 2015. - A short 100 to 200 word biography for the donor must be included. - Recipients must be available to attend a scholarship banquet on April 30th. 1-3-13/MT Brigham City Scholarship Application Utah State University Brigham City Regional Campus Summer 2015 Please print clearly Name______________________________________________________________________________________________________________________ Address________________________________________________City__________________________State ______ Zip Code______________ Student A# ______________________________________________Telephone_____________________________________________________ E-mail_____________________________________________________________________________________________________________________ What is your declared major? ________________________________________ Are you currently admitted to USU? ________ What is your overall GPA _________________ Will you have earned 60 credits by the end of spring 2015? _______ Please complete a Goal Statement that includes (1) your educational goals, and (2) how your education will benefit you and society. Type your statement and attach it to this application form. Certification of Lawful Presence in the United States (Required) Utah Code 63G-12-402 requires the University to verify the lawful presence in the United States of individuals who apply for tuition waivers, scholarships, and grants administered by the University. Individuals who apply for these benefits are also required to certify under penalty of perjury that they are lawfully present in the United States. (Please note that you can still be considered for admission even if you cannot certify that you are lawfully present in the United States.) I certify under penalty of perjury that I am either a United States citizen, or a qualified alien that is lawfully present in the United States. [ ]Yes [ ]No ______________________________ Applicant Name (Please Print) __________________________ Applicant Signature ________________ Date I certify the information provided on this application is correct to the best of my knowledge and I authorize the release of this information and/or my transcripts to any person or institution involved in the awarding of the above scholarship. This scholarship will be reported to the USU Financial Aid Office and may impact any loan or grant being awarded. Signature Date For Office Use: Date received______________________________________ Received by_________________________________ Scholarship decision no □ yes □ Comments: ___________________________________________________________________________________ 1-3-13/MT
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