no later than January 15, 2017

Transcription

1 Freshman Application As you prepare your application, you are advised to download and save a copy of the application so that you can complete a rough draft with full and complete answers before completing the application online. When you are satisfied you have complete and correct answers to the questions, you should begin the online application. Be sure to edit your essays carefully and to stay within in the word limits. Applications and all supporting materials must be received by the UNT Terry Scholarship Office no later than January 15, 2017, to be eligible for consideration. There will be no exceptions to this deadline. You must be logged in with your UNT EUID and password in order to submit an application. Please log in using the box to the left. Browser: Processing Section Approved to Committee: Approved to Foundation: Letter of Recommendation Arrived: Transcripts Arrived: Applicant Information Student Name: * Last Name: * Preferred Name: Middle Name:

2 Student ID UNT ID abc1234: * Student ID-Eight digit UNT ID 1XXXXXXXX: * County: Permanent Address: Permanent City: Permanent State: Permanent Zip: (One you access daily): * Alternate Cell Phone: Home Phone: Birth Date: * Age: Birthplace: Gender: - ne - Race or Ethnic Background: Black/African American Asian American White(non-Hispanic)/Caucasian Hispanic American Indian/Alaskan Native Native Hawaiian/Native American Pacific Islander

3 Are you a US citizen?: - ne - If Permanent Resident, A#: If you are a Permanent Resident, indicate type of card: C Texas Resident: * - Select - Reference 1 Reference 1 Name: * Reference 1 Institution: Reference 1 Phone Number: Reference 1 Mailing Address: Reference 1 * Reference 2 Reference 2 Name: * Reference 2 Institution: Reference 2 Phone Number: Reference 2 Mailing Address: Reference 2 * Educational Data High School Name: High School Address: High School City: High School State: High School Zip Code: Intended Major: Name of High School Counselor: *

4 of High School Counselor: * Phone Number of High School Counselor: * High School GPA: Scale: Did your high school have a class ranking system?: Graduation Date: Class Rank: out of: students Number tied for this rank: PSAT Verbal: Math: Writing Skills: Selection Index: Date of Test: SAT Critical Reading and Writing: Math:

5 Composite: Date of Test: ACT Composite: Date of Test: Indicate the level of recognition you have achieved in the following scholarship competition(s). National Merit: Did you receive the National Merit scholarship?: Date of National Merit: National Achievement: Did you receive the National Achievement scholarship?: Date of National Achievement:

6 National Hispanic: Did you receive the National Hispanic scholarship?: Date of National Hispanic: Have you applied for admission to the Honors College at UNT?: Have you been accepted for membership in the Honors College at UNT: Pre-AP, Advanced Placement (AP), International Baccalaureate Program (IP), or Dual Credit (DC) Coursework Taken in High School For sections III and IV, fill spaces provided completely. Do not submit a resume in lieu of completing sections III and IV. Important: If you are a recruited athlete, DO NOT include any information about your athletic participation or achievements on this application. List all Advanced Placement, International Baccalaureate, or Dual Credit coursework taken your sophomore, junior, or senior year. Sophomore Level Coursework Course 1 Course Name: Type: - ne - Date: Final Grade:

7 Course 2 (add additional course information as needed) Course 3 Junior Level Coursework Course 1 Course 2 Course 3 Course 4 Course 5 Senior Level Coursework Course 1 Course 2 Course 3 Course 4 Course 5 Course 6 Course 7 Employment, Activities, Service, and AwardsEmployment, Internships, and Summer Activities Important: If you are a recruited athlete, DO NOT include any information about your athletic participation or achievements on this application. List all of your previous and current jobs or internships. Include your job title, your employer's name, how many hours per week you worked, the number of weeks you worked, and the dates of employment. List your most recent activities first. Job 1 Position/Job Title: Employer: Hours per Week: Number of Weeks: Beginning Date: End Date:

8 Job 2 (add additional job information as needed) Job 3 Job 4 Job 5 Job 6 Job 7 Extracurricular Activities and Leadership Positions In order of importance to you, list your top six extracurricular activities (include band, clubs, affiliations, etc.) and the position(s) you held. Activity 1 Organization/Activity Name: Position(s) Held: Description of Activity: s Participated: Freshman Sophomore Junior Senior Activity 2 (add additional activities as needed) Activity 3 Activity 4 Activity 5 Activity 6 Community and/or Volunteer Service Describe your role in the organization, the type of organization you were associated with, how many hours of service you devoted each week, the number of weeks, and the dates you participated in each activity. List your most recent service first. Service 1 Place of Service: Description of Service:

9 Hours per Week: Number of Weeks: Beginning Date: End Date: Service 2 (add additional community service as needed) Service 3 Service 4 Service 5 Service 6 Service 7 Awards, Special Honors, and Distinctions Award 1 Award/Distinction/Honor: Description/Basis for Award or Sponsor of Award: Completion Level: - ne - s Participated: Freshman Sophomore Junior Senior Award 2 (add additional awards as needed) Award 3

10 Award 4 Award 5 Award 6 College Plans Will you be the first in your family to graduate college? : - ne - Why have you chosen to apply to the University of rth Texas?: Please limit your response to a maximum of 50 words. List, in order of preference, the top six colleges or universities you are considering attending. Be sure to rank the University of rth Texas among your choices. 1: 2: 3: 4: 5: 6: What is your intended academic major?: Why have you chosen your academic major?: Please limit your response to a maximum of 50 words. Briefly describe any academic plans beyond earning your bachelor's degree: Please limit your response to a maximum of 50 words. What are some of your life's goals and objectives?:

11 Please limit your response to a maximum of 100 words. Have you ever been married?: - ne - Student's Total Income for 2015 (Round to the nearest dollar):$ Student presently lives with?: - ne - Parent/Guardian 1Parent/Guardian 2 Are you (or your family) receiving financial assistance (such as Social Security) from any local or federal government entity?: Assistance Received Assistance 1: Type: Assistance 1: Amount Annually (Round to the nearest dollar):$ Assistance 2: Type: Assistance 2: Amount Annually (Round to the nearest dollar):$ Assistance 3: Type: Assistance 3: Amount Annually (Round to the nearest dollar):$ If yes, please indicate the type of assistance and amount received per month: Value or your parents'/guardians' other investments (not including home, Round to the Nearest Dollar):Net Value: $ Value or your parents'/guardians' businesses, farms, and/or ranches (not including home, Round to the nearest dollar):$ Parents' or Guardians' Adjusted Gross Income for 2015 (from Form 1040/1040A, Round to the nearest dollar): *$

12 Was your family's 2015 income the same as it was for 2014?: * - Select - Did it increase or decrease?: Change Estimated amount of change (Round to the nearest dollar):$ Please provide the information for all children less than 25 years of age in your household. Child 1 First Name: Last Name: Age: Relationship: School or College: in College: Self Supporting: - ne - Child 2 (add additional children information as needed) Child 3 Child 4 Child 5 Child 6 Number attending college in (including yourself): Funds for college saved by you:$.00 Funds for college saved by others:$.00 Do you have a Texas Tomorrow Fund or 529 college savings plan?: - ne - What is the plans value?:$.00 Projected parental support for your college expenses (annual amount):$.00 Parents'/Guardians' total cash savings (not limited to college):$.00

13 Please describe any additional factors or circumstances demonstrating your financial need: Please limit your response to a maximum of 100 words. List other scholarships for which you have applied at the University of rth Texas for the academic year Scholarship/Grant 1 Scholarship/Grant Name: Duration of Award (1 year or number of years): Amount per :$.00 Scholarship/Grant 2 Scholarship/Grant Name: Duration of Award (1 year or number of years): Amount per :$.00 Scholarship/Grant 3 Scholarship/Grant 4 Scholarship/Grant 5 List other scholarships for which you will receive at the University of rth Texas for the academic year Scholarship/Grant 1 Scholarship/Grant Name: Duration of Award (1 year or number of years): Amount per :$.00 Scholarship/Grant 2 Scholarship/Grant Name: Duration of Award (1 year or number of years): Amount per :$.00

14 Scholarship/Grant 3 Scholarship/Grant 4 Scholarship/Grant 5 Essay 1: Childhood Environment: * In approximately 250 words: What was the environment in which you were raised? Describe your family, home, neighborhood, or community, and explain how it has shaped you as a person. Please prepare your essay in Word, edit it carefully, and then upload it. Essay 2: Leadership Experience: * In approximately 500 words: Describe an example of your leadership. Be sure to describe your actions and the actions of those around you and to explain what you accomplished. Please prepare your essay in Word, edit it carefully, and then upload it.