Scholarship Application : Purdue University College of Technology

2009/2010 upperclass Scholarship Application.

Applicant Information:
Name*:	First: M: Last:
Address*:
City/State/Zip*:	/ /
Country*:
Eligibility*:	Are you a United States citizen or legal resident? yes \| no
Gender:	female \| male
Ethnicity:	African American Asian Caucasian other ethnicity or tribal affiliation: Hispanic Native American Pacitic Islander
Location*:	If not West Lafayette, be sure to check with your location for more scholarship opportunities.
Email*:
Purdue ID #*:	format: 10 digits (xxxXXXxxxx) I don't know my PUID #, how do I find it? You may find your PUID by logging in to SSINFO at http://www.ssinfo.purdue.edu. This is Student Services Information on the Web. Since you do not have a PUID to login with, you may used your temporary login information which can be found HERE Once looged in you may click on the "Find your PUID" link located under "Help Resources on the right link bar.
	College of Technology major:
Credit Hours*:	How many credit hours do you plan to take in the fall:
Federal Aid*:	Have you, or will you be completing a Free Application for Federal Student Aid (FAFSA) form? yes \| no
Fall '09 Semester Classification*:
Anticipated Graduation Date*:	Month #: Year:
Cumulative GPA*:
Work Information:
	Will you be on a Co-Op work session: Fall '09 or Spring '10
	Will you be doing a campus internship: Fall '09 or Spring '10
Please answer these questions:
	Describe your university/department/community activities and academic accomplishments. Clarify your involvement and activity as member, officer, committee chair, project leader. Explain how the activity helped other COT students, your department, the college, or the University.
	What are your career objectives and long-term professional goals? If you have preference for a particular segment of the overall industry, include this in your response.
	Describe your personal attributes that you feel should be considered by the selection committee.
	Describe how you and/or your activities enhance the diversity of our program.
	I authorize Purdue University to release personally identifiable information from my education record to outside entities for scholarship selection, to scholarship donors and/or for publicity purposes regarding the awarding of a scholarship. This could include items such as your class, major, and GPA but not your PUID. I agree

In accordance with Purdue policies, all persons have equal access to Purdue University's educational programs, services and activities, without regard to race, religion, color, sex, age, national origin or ancestry, marital status, parental status, sexual orientation, disability or status as a disabled or Vietnam-era veteran. A more complete statement of Purdue's policies of equal access and equal opportunity is also available. If you have any questions or concerns regarding these policies, please contact the Office of the Vice President for Human Relations at vphr@purdue.edu or 765-494-5830.

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