Undergraduate Scholarship Application

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1 Undergraduate Scholarship Application Scholarship Application Requirements: 1. Completed application with signature. 2. Personal narrative statement. 3. Only completed applications received by the posted deadline will be considered. Choose the scholarship (s) for which you are applying. David W. Thomas Scholarship Emma and Vittorio Argento MS '76 PhD '89 Scholarship Lennox International Inc: Linda G. Alvarado Scholarship in Engineering Plano Conservancy for Historic Preservation Scholarship for Electrical Engineering Texas Instruments Endowed Electrical Engineering Undergraduate Scholarship

2 Personal Information Last Name: First Name: MI: UTD-ID: Address Street: City State ZIP address: Home telephone: Sex: Work telephone: Are you currently a U.S. citizen or permanent resident? Yes No Academic Information Semester first enrolled at UTD: Fall Spring Summer Year Semester to be first enrolled in ECS: Fall Spring Summer Year Total credits completed: Earned Number of other transfer credits completed: Earned Cumulative grade-point average: Major: Current classification: Freshman Sophomore Junior Senior Anticipated graduation date from UTD:

3 Work History Please list any organizations or companies for which you worked as an employee or volunteer. Include the length of employment and a brief description of your duties. You are welcome to submit a resume with this application. Name of Company/Organization Dates Worked Job Title/Description Honors and Activities Please list membership(s) in any university or civic groups (including scholastic). Include any elected position or office held in the organization and the year(s) of involvement. Please list honors, prizes and awards for scholastic and/or creative achievement.

4 Narratives Please write a statement about why your academic performance and financial need deserve scholarship support. How would receiving this award make a difference to you? Please submit a separate page if desired. Please provide a personal statement telling us why you feel you should receive this scholarship and how this scholarship will support your educational goals at UT Dallas. Tell us why you chose to major in engineering or computer science and what kind of career you are planning to pursue. Other Please provide any additional information you would like us to take into consideration.

5 Certification I certify that the information provided in this application is complete and accurate. I understand that providing false or misleading information on this application or other documentation may disqualify me for consideration of my application or disbursement of scholarship funding. Further, I understand that the information will be used by recognized university scholarship committees to evaluate and award scholarships. I agree to release my records to my scholarship's administrators and/or donors to use application materials, including name, classification, major, mailing address, and cumulative GPA for scholarship purposes. I understand this authorization is valid one time for a single release of information as allowable per the Family Education Rights and Privacy Act of 1974 (FERP A). The addition of outside funding toward your educational expenses such as scholarships and grants, tuition adjustments due to exemptions and waivers, changes in enrollment, changes in state residency, estimated costs, eligibility, and/or housing status may require that awards be adjusted. Such adjustments may result in a reduction of aid. If you will receive any financial aid not listed above, such as outside scholarships, you are required to report each source and amount to our office. Student's Signature Date Texas Instruments Endowed Electrical Engineering Undergraduate Scholarship only: Application with all required documents must be enclosed in a sealed large envelope and received on or before 5:30pm April 30, 2018 at the front desk in ECS Student Services located at ECSS or may be submitted via to kimberly.james-romero@utdallas.edu by 5:30pm April 30, All other scholarships: Applications with all required and optional documents must be enclosed in a sealed large envelope and received on or before 5:30 p.m. February 28, 2018 at the front desk in ECS Student Services located at ECSS

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