Palmer Scholarship Application Part I
Please Print All Information
Personal Information First Name ____________________________________ Last Name _______________________________________ Home Phone __________________________________ Cell Phone _______________________________________ Stritch E-mail __________________________________ Alternate E-mail ___________________________________
Education Abroad Program Location and Semester/Year Foreign University Name_________________________________________ Country__________________________ I have been accepted by the Stritch International Office to study abroad during:
Fall Year:
Academic Information
Student ID#:____________________
Academic Year (circle) Freshman
Sophomore
Junior
Senior
Other:
Spring Year:
Current GPA ________
Major ________________________________________ Minor ____________________________________________ I have been/will be a Stritch education major/minor for one academic year prior to my semester abroad
Yes
No
I have attached a copy of my:
Stritch Financial Aid Award Unofficial Academic Transcript Palmer Scholarship Essay (please send an electronic copy as an attachment)
Yes Yes Yes
_________________________________________________________________________________________________________
Scholarship Applicant Name
Applicant Signature
Date (mm/dd/yyyy)