Louis H. and Betty J. Quayle Scholarship Application ACADEMIC YEAR APPLICATION DEADLINE: March 15, 2019

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Louis H. and Betty J. Quayle Scholarship Application 2019-2020 ACADEMIC YEAR APPLICATION DEADLINE: March 15, 2019 Louis H. & Betty J. Quayle Scholarship Endowed in 2006, the Quayle Scholarship provides significant funding to support outstanding NAU graduate students who are members of a federally recognized Native American nation or tribe. Amount: up to $4000 per semester Criteria: Applicants must be part of a Native American Tribe or Nation and must provide a copy of tribal enrollment document (e.g. Certificate of Indian Blood, enrollment card) with application Academic experience, community service, extracurricular activities, financial need, and professionalism of application will all be considered Must be enrolled full or part time for the 2019-2020 academic year Please read and follow all instructions carefully. Fill in all fields. Type N/A where not applicable. Incomplete applications may not be considered. Save completed scholarship application form, your personal statement, and any other supporting documentation as ONE PDF DOCUMENT for submission. You can combine pdf documents using Acrobat software or an online service. Save your document with the file name LastName_FirstName_Quayle_Application_2019-20.pdf. Send PDF attachment via e-mail with the subject Quayle Application LAST NAME to: GradAwards@nau.edu from your NAU student email All communications regarding this scholarship will go to your NAU student email. All applications must be complete and legible to be considered. Incomplete applications may be rejected. Handwritten applications are discouraged but will be accepted. Please type your application if possible. All admitted NAU students have both an NAU ID number (a seven digit number with only numbers) and an NAU student email address (typically your initials followed by one to four numbers). Both of these must be included on your application where indicated. If you are graduating prior to the Fall 2019 semester, you are not eligible for this scholarship. This scholarship is available only to students who will be enrolled in classes full time or part time for the Fall 2019 and/or Spring 2020 semesters. Awards can only be disbursed for one or both of these semesters. All applications require a personal statement. All Quayle Scholarship applicants must be members of federally recognized Native American tribes or nations, and applications must include a copy of tribal enrollment document (CIB, enrollment card, etc.). A letter of recommendation is required with your application. These should be included with your application OR emailed directly from your recommender to the Graduate College at GradAwards@nau.edu no later than March 15, 2019. Letters should address academic accomplishment and potential along with notable extracurricular or professional experiences. Award decisions will be communicated to all applicants no later than May 9, 2019. Checklist for application submission: Completed application form Personal statement (details on page 4) Tribal enrollment document (CIB, Certificate of Indian Blood, etc.) Letter of recommendation (attached to application OR emailed by recommender) All submitted documents must be combined into one PDF document and sent to GradAwards@nau.edu no later than March 15, 2019. Cover Sheet Page 1 of 5

Application Coversheet Please contact GradAwards@nau.edu with any questions regarding this scholarship. Name: NAU ID Number: This application is for scholarships awarded through the Graduate College and can only be used for students admitted into a graduate-level degree program at NAU as of the Fall 2019 term. 1. Are you a member of a federally recognized Native American tribe or nation? 2. Have you been admitted and will attend NAU as a degreeseeking graduate student for 2019-2020 academic year? Please be aware that academic years begin in Fall semesters. 3. Do you plan to be enrolled full time (9+ credit hours) or part time for the Fall 2019 semester? Full Time Part Time 4. Do you plan to be enrolled full time (9+ credit hours) or part time for the Spring 2020 semester? Full Time Part Time I plan to graduate Fall 2019 5. Do you have a Graduate Assistantship for 2019-20 academic year? 6. Are you receiving funding from other sources for the 2019-20 academic year? These may include scholarships, loans, grants, fellowships, etc. Please do not include GA positions or tuition waivers., 10 hours per week, 20 hours per week or unknown 7. Are you receiving a departmental tuition waiver for the 2019-20 academic year? 2019-2020 ACADEMIC YEAR APPLICATION DEADLINE: March 15, 2019 Page 2 of 5

Application Form Name: NAU ID Number: NAU E-mail Address: Phone Number: Mailing Address: City: State: Zip: Please list your nation or tribe: *The Quayle Scholarship is only available to members of federally recognized Native American tribes and nations. Applicants must provide a copy of their tribal enrollment document (e.g. Certificate of Indian Blood, enrollment card) with this application. Collegiate Educational Background: Please list all of your previous collegiate schools and degree programs. You must include your current/future NAU graduate program in the first column (if you have not yet begun your NAU graduate degree, you may type not started for the GPA field). You must also include your undergraduate degree and any prior graduate degrees earned. Please attach extra sheets if necessary. School Name: City/State: Current/Future Grad Program College/University College/University rthern Arizona University Flagstaff, AZ Dates Attended (or expected): Major/Program Name: Degree (BA, MA, etc.): Month/Year Degree Awarded (or expected): Final/Current GPA: Scholarships & Financial Aid Awards: List and indicate all sources and amounts you have applied for or know you will receive for 2019-2020 academic year. If you have applied but have not yet been awarded, indicate this with (Applied). 1. $ 2. $ 3. $ 4. $ 5. $ 6. $ 7. $ 8. $ Recommender Information: Please ensure this information is correct. If your recommender is emailing your letter of recommendation to us, be sure the email address below matches that which they are sending your letter from. Name Telephone E-mail Relationship Page 3 of 5

Additional Information (attach additional sheets if necessary): Past honors and awards: Current or past significant research, scholarship, or creative activities related to degree or field: Current and past extracurricular activities, including community service and volunteer activities: Personal Statement Guidelines Please attach a statement that is between one and two pages in length. In this statement, we would like to see a holistic picture of you and your academic journey to date. Your statement should include, but is not limited to, the following information: Why you are pursuing a graduate degree in your discipline; The relationship between your degree and your career goals and aspirations; How you hope to impact your discipline and/or society as a whole. The impact receiving this scholarship would have. Page 4 of 5

Supplemental Information: Please answer the following questions. If you indicate a yes response to questions 1 or 2, please include an additional page with details on your response. 1. Are you a returning student? (i.e. you started your graduate education, left school, and are now returning) 2. Are you eligible for tuition benefits through employment, or as a dependent, domestic partner, or a spouse of an employee at a state university in Arizona? (i.e. are you eligible for reduced tuition for these reasons). 3. Are you considered an Arizona resident? I confirm by my signature and/or printed and/or typed name below that the information I have provided on this application is accurate and true to the best of my knowledge. I understand that the scholarship is awarded at the discretion of the Graduate College, and I give Graduate College staff permission to contact my school(s) or other references for verification of this information. I also understand that by asking to be considered for a Graduate College scholarship, I am giving consent for NAU to release appropriate personal information to donors or within press releases or feature articles. This includes, but is not limited to, my application information (resume, essay, etc.), year in school, major, etc. FERPA protected information will be released. I also verify that I have read and understand all rules and qualifications provided by the Graduate College regarding this scholarship. Signature/Printed/Typed Name Date Page 5 of 5