Anticipated total amount over the full term of this award.

$2,000.00

1. What degree are you seeking?
   • 1. What degree are you seeking
   • 2. If you selected Other, please specify below.
2. In the fall of the next academic year, I will be a...
3. What is your anticipated date of graduation or program completion?
   • Month?
   • Year?
4. Is your program fully online?
5. Who is your academic advisor?
6. Will you be enrolled in dissertation hours during the upcoming academic year? You are ineligible for scholarship funds if you have exceeded 18 hours of dissertation credits and no longer need to be enrolled full-time.
7. Teacher Licensure
   • 1. Do you currently hold a teacher Licensure?
   • 2. If yes, please provide Licensure areas below.
8. Do you intend to add a ESOL endorsement?
9. Do you intend to add a special education endorsement?
10. When you graduate, are you planning on working with individuals who have special needs?
11. Have you taught swimming and/or water safety?
12. Are you a dependent of an active duty or retired military personnel?
13. If asked, could you provide documentation that you are a member or citizen of a Federally Recognized Tribe?
14. Kansas High School
    • 1. Did you graduate from a Kansas High School?
    • 2. If yes, did you graduate with high school GPA of 3.5 or above?
    • Please provide the Name, County, and Year of graduation. If No, please put N/A
15. What is the population of your home town?
16. Employment information (please provide up to 3 employment opportunities)
    • 1. Are you employed for the next academic year?
    • 2. If yes, what is your job title (s) and how many hours a week do you work for pay
17. What other awards and/or scholarships will you be receiving for the next academic year? Include the source of funding and amount.
18. GA/GTA/GRA for next academic year
    • 1. Will you have an appointment as a GA/GTA/GRA for next academic year?
    • 2. What is your role for the next academic year:
    • 3. What is your percent appointment for the next academic year:
19. Explain why you would be a good candidate for a SOE&HS scholarship based on your academic and/or extracurricular performance while enrolled at KU.
20. What is your motivation for pursuing your degree in SOE&HS and how does it relate to your future goals?
21. Please describe any financial circumstances that you would like the committee to take into consideration when evaluating your application. (Example: expenses vs. income, family issues, employment, etc.)
22. Please upload a curriculum vitae (CV) or resume
23. Statement of Consent
    
    Responsibility and Accuracy Please read this section carefully and check the box below. The box (below) must be checked in order for your application to be considered complete and therefore eligible for consideration by the Scholarship Committee.
    
    
    • 1. I understand that my academic work will be reviewed to determine my academic eligibility. I understand that if I am selected to receive a scholarship, my award is contingent upon full acceptance to the School of Education and Human Sciences by the Fall semester.
    • 2. I understand that if I am selected to receive a scholarship award through the University of Kansas School of Education and Human Sciences, the following will be expected of me as a recipient: write a thank you letter to my donor(s) and attend the annual School of Education and Human Sciences reception if my donor attends.
    • 3. I hereby certify that the statements herein are true to the best of my knowledge. I understand that the decisions of the scholarship committee related to me will be based on the information I have provided in my scholarship application.
    • 4. I hereby certify any award(s) received by me through the School of Education and Human Sciences Scholarship Program will be used solely for expenses related to continued full-time enrollment (minimum 12 hours per semester for undergraduate students and 6 hours per semester for graduate students) in the University of Kansas School of Education and Human Sciences. I understand if I drop below the minimum hours required for full-time status, I may not receive my scholarship.
    • 5. I understand that to be considered for a scholarship based on financial need I will need to fill out a FAFSA or ISNAW form.
    • 6. I understand that submitting this application does not guarantee I will receive funds
    • 7. The University of Kansas is committed to providing programs and activities to all persons, regardless of race, religion, color, disability, national origin, ancestry, sexual orientation, gender identity or expression, marital or parental status, and, to the extent covered by law, age or veteran status.
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