Charles and Rae Perkins Scholarship Utah State University Brigham City Regional Campus Fall 2015-Spring 2016 Description: The Charles and Rae Perkins Scholarship was created to assist students in obtaining an education. The Perkins believed in education even though neither Charles nor Rae completed a college degree, and it was education that helped them to a high-degree of financial success. The couple named USU the primary beneficiary of their estate with the goal of helping dedicated students complete their degrees without the added burden of financial difficulty. In their honor the Charles and Rae Perkins Student Lounge was created within the Milton P. Miller building on the Brigham City Regional Campus. Scholarship amount Nine $2,000 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 - Qualify for Federal Financial Assistance for the 2015-2016 school year - Will be at least a sophomore (30 or more credits) beginning fall 2015. - Overall GPA of 3.00 or higher. The GPA posted after fall semester 2014 will be used to determine overall GPA. Criteria for Maintaining Scholarship: - Half of the scholarship is for fall semester 2015; the other half is for spring 2016. Funds cannot be used in any other semester. - Receive a minimum of a 3.0 GPA for fall semester 2015 to be awarded the second semester in spring 2016. - Cannot be used with any other USU Brigham City Regional Campus sponsored financial award. - Not redeemable for cash - Must be enrolled for a minimum of 6 credit hours during the scholarship period - Must be enrolled in Brigham City sections of classes only. Application Procedure - Complete the Charles and Rae Perkins Scholarship application form (including your 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 letter of appreciation must accompany the Acceptance Agreement addressed to: Trust Officer of the Charles and Rae Perkins Scholarship, Bank of Utah - A short 100 to 200 word biography for the donor must be included. - Recipients must be available to attend an awards banquet on April 22nd. 1-3-13/MT Charles and Rae Perkins Scholarship Application Utah State University Brigham City Regional Campus 2015-2016 Please print clearly Name_____________________________________________________________________________________________________________________ Address________________________________________________City__________________________State ______ Zip Code____________ Student A# ______________________________________________Telephone____________________________________________________ E-mail________________________________________________________________________ What is your Estimated Family Contribution (EFC) score ________ Are you currently admitted to USU? _________ What major do you plan to pursue? ________________________________ What is your overall GPA? ____________________ Will you have earned 30 credits or more by the end of summer 2015? ________ Please complete a goal statement that includes (1) your financial need, (2) your educational goals, and (3) 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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