Merit-Based Donor Scholarship Online Application Form

Applicant Name: *		NLU ID#:
Address 1: *		Address 2:
City: *		State & Zip: *	-- AK AL AR AZ CA CO CT DC DE FL GA HA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY
Primary Phone: *		NLU Email: *

Campus
Campus you currently attend:
Chicago Elgin Skokie Lisle
Wheeling Florida Regional Milwaukee/Beloit

Academic Level
Undergraduate Graduate

If Undergraduate, what will your status be at the beginning of next school year?
Freshman (0-44 qtr hrs) Sophomore (45-89 qtr hrs)
Junior (90-134 qtr hrs) Senior (135 +qtr hrs)

If Graduate:
Please indicate the number of hours you have completed:

Academic Information

College to which you have been admitted: *
-- National College of Education College of Arts & Sciences College of Management & Business

Major: *

GPA (cumulative): *

Current Enrollment

These scholarships are for current NLU students with an established academic record. To be eligible to apply, a student must complete at least one term prior to April 30, 2012.

If you will be Student Teaching during the 2012-2013 Academic year, please specify the term:
Fall 2012 Winter 2013 Spring 2013

Please refer to the Merit-Based Scholarship List and determine those scholarships whose eligibility criteria you meet. Indicate below the scholarship(s) for which you wish to apply for by selecting each scholarship. You may select as many scholarships as are applicable but will only be considered for those you indicate. *

Please select from the following options Edna Dean Baker Award The Maxine Cohn Memorial Teaching Scholarship Daisy Collett Memorial Award Mrs. John N. Crouse Award Paul Galvin Memorial Award Frederick Llewellyn Gross Scholarship Lynore and Robert A. Greising Memorial Award Elizabeth Harrison Award Samuel Johnson Award Eva Grace Long Award Henrietta Louis Award Christine Smith Award Byron Walter Memorial Award Friends of American Writers Jane Roiter Memorial Scholarship Millennium Scholars Award The Kathryn and Lloyd Bettis Scholarship Taub Family Scholarship Joyce Dickie Memorial Scholarship Jewel Memorial Fund K. Richard Johnson Award Marjorie Lee Memorial Scholarship Junior League of Evanston-North Shore Scholarships John Jeffry Loius III Award Susan Osborne Award Miriam Wellikoff Scholarship Award
you may select multiple Scholarships
by holding the Ctrl key while clicking.

Please list and describe briefly all on-campus activities, clubs or organizations in which you have been an active participant in the past year: *

Please list and describe briefly any volunteer (unpaid) work that you have completed in the past year: *

Please list and describe your off-campus activities and involvement within community organizations and causes not listed above, including a contact name and phone number for each activity: *

Please list any scholarships or awards you currently receive from NLU or any other source. This does not disqualify you for consideration of Merit-Based Scholarships:

Please provide us with any additional information that you feel would help us in determining your eligibility for the scholarship(s) in the essay you submit with this application. You may include information regarding your chosen career path, professional philosophy, and your personal/family situation. You need to write an essay specifically for the purpose of applying for Merit-Based Scholarships at NLU. DO NOT submit your "Why Teach" or "Philosophy of Education" essay. Be sure your essay includes all information related to the specific criteria and the essay guidelines offered on the Merit-Based Scholarship webpage.

Scholarship winners will be announced in July of 2012 and the funds are awarded the following academic year beginning with the Fall 2012 term. Awards are generally disbursed in even increments by term. Please note that award funds are to be applied to charges incurred during the 2012-2013 academic year and are not to be applied to prior balances.

In addition to your completed online application form, all supporting materials must be emailed to the scholarship coordinator by 11:59 p.m., April 20, 2012:

Donor Relations & Scholarship Manager
stscholarships@nl.edu

I understand that all information I have provided is true. I understand that names of scholarship recipients are public information and will be posted on the NLU website and shared with donors. I understand that in addition to the online posting, recipients will be notified via student email by July of 2012. I understand that all recipients are selected by a committee of the NLU Faculty Senate whose decisions are final. If I receive a scholarship(s), I agree to write the donor expressing my appreciation for the award. I understand that I will be expected to participate in a scholarship ceremony in the Fall of 2012 at the NLU campus in Skokie. I understand that my application will only be accepted if completed online with all supporting documents emailed to the scholarship coordinator at stscholarships@nl.edu by 11:59 p.m., April 20, 2012.

Please type your name to acknowledge the above guidelines:

Date: Wednesday, May 23, 2012