Gift Amount: $____________________________
Please check one:
_____ Given by:
_______________________________________________
_____ Given in Honor of:
_______________________________________________
_____ Please place in the general scholarship fund
_____ Please contact me about setting up an endowment
_____ Other: Please list
________________________________________________
CLASSIFICATION (choose as many as you want)
Freshman
_____ Sophomore
_____ Junior
_____
Senior
_____
Graduate
_____
GRADE POINT AVERAGE
2.75 or greater
_____ 3.0
or greater _____
3.2 or greater
_____ 3.5
or greater _____
None of the above _____
MAJOR (choose as many as you want)
Civil
____ Chemical
____ Computer
Science ____
Electrical
____ Mechanical
____ Industrial
Technology ____
Additional majors if Graduate was option:
Natural Gas
____ Industrial
____
Environmental ____
LETTERS OF RECOMMENDATION
Required
____ (if required, how many?) Not
required ____
REQUIRED ESSAY
Yes
____
No ____
If yes, list topic and number of minimum/maximum words:
_____________________________
_____________________________________________________________________________
(Some common topics: “Why I chose engineering as a
career”, “Who has been the most influential person in your life?”
AWARD
Amount of each award
________
If one award do you wish to
split (½ in Fall, ½ in Spring)? ________
SCHOLARSHIP COMMITTEE
College Scholarship
Committee : ____
Departmental Scholarship Committee : ____
OTHER CRITERIA
Please write in any additional criteria that was not listed
above that you would like to include:
______________________________________________________________________________
________________________________________________________________________________________