Terry Foundation Scholarship Application Guidelines for The University of Texas at Arlington

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2018-19 Terry Foundation Scholarship Application Guidelines for The University of Texas at Arlington Qualifications To be considered for the Terry Foundation Scholarship, students must: Have a record of leadership Demonstrate financial need Have strong academic abilities, as evidenced by grades and SAT/ACT scores Be a 2018 graduate of a Texas high school or Texas home-school Apply for admission to UT Arlington as a full-time student for 2018-19 no later than February 1, 2018 Be willing to live on campus for at least the first year Be a U.S. citizen or permanent resident Application Summary and Deadlines Apply to the UT Arlington no later than February 1st. Submit your completed Terry Scholars application by Tuesday, February 6th. File a FAFSA on-line before March 15th. You are encouraged to print a copy of your Student Aid Report from your 2018-2019 FAFSA and have it with you if you are selected for an interview. Apply for on-campus housing no later than April 15th. For more information, please refer to the UT Arlington Housing website (uta.edu/housing). First year Terry Scholars are required to live on-campus in a designated living-learning community. Nomination Process Following review of all completed applications received, UT Arlington will nominate 30 students for the Terry Foundation Scholarship. From this group, the Terry Foundation will award approximately 14 scholarships for use during the 2018-2019 academic year. Please know that UT Arlington serves as a nominating body only; all final decisions regarding scholarship awards are made by the Terry Foundation. Additional information about the Terry Foundation Scholarship is available at www.terryfoundation.org Submitting Your Application Submit your completed application, the names and contact information for the two individuals who are willing to provide a letter of recommendation for you, online through the MavScholarShop. The link can be found online at www.uta.edu/terryscholars Questions? Contact University College by emailing terryscholars@uta.edu. Last updated January 4, 2018

STUDENT NAME: UTA ID: Page 1 2018-19 Terry Foundation Scholarship Program Application Fill out each section of the application form completely, taking care to respond to each question in the space provided. All applications must be TYPED. I CERTIFY the information I am providing is complete and correct to the best of my knowledge. If my application is accepted, I agree to abide by the policies, rules, and regulations of the Terry Foundation. I understand that The University of Texas at Arlington is solely a nominating body. The University reviews applications received to nominate students for the Terry Foundation to interview. I authorize the University to share my application information with the Terry Foundation if I am nominated for an interview. I authorize The University of Texas at Arlington and/or the Terry Foundation to verify the information I have provided. I further understand that this information will be relied upon by the Terry Foundation in determining my financial eligibility and that the submission of false information is grounds for rejection of my application, and/or withdrawal of an offer of scholarship. I understand I may be asked for additional information to be considered for the Terry Scholarship. Applicant s signature: Date: YOUR SIGNATURE IS REQUIRED TO PROCESS YOUR APPLICATION. I. STUDENT INFORMATION Legal Name (Last, First, Middle): Preferred Name: Permanent Address: City: State: Zip Code: County: Home Phone: Date of Birth: Alternate/Cell Phone: Gender: Email Address (one you access daily): US. Citizen? YES NO Permanent Resident? YES NO If YES, indicate type of card: I551 I551C Texas Resident? YES NO Birthplace: Ethnic Background: How do you describe yourself? Anticipated College Major: II. HIGH SCHOOL INFORMATION Name and City of High School: Your High School Counselor: School Phone/Ext: Your High School Counselor s Email: High School GPA: Scale: Graduation Date: Class Rank: out of: students Number of students tied for this rank:

STUDENT NAME: UTA ID: Page 2 II. HIGH SCHOOL INFORMATION (continued) Test Scores PSAT Verbal: SAT Mathematics: ACT Composite: Math: Evidence-Based Reading Date of Test: Writing Skills: & Writing: Selection Index: Composite: Date of Test: Date of Test: Indicate the level of recognition you have achieved in the following scholarship competition(s). National Merit: Date: National Achievement: National Hispanic: Date: Date: III. PRE-AP, ADVANCED PLACEMENT (AP), INTERNATIONAL BACCALAUREATE PROGRAM (IB), OR DUAL CREDIT (DC) COURSEWORK TAKEN IN HIGH SCHOOL For sections III & IV, fill spaces provided completely. Do not submit a resume in lieu of completing sections III & IV. List all Advanced Placement, International Baccalaureate, or Dual Credit coursework taken your sophomore, junior or senior year. Sophomore Level Coursework AP/IB/DC Credit Hours Final Grade Junior Level Coursework AP/IB/DC Credit Hours Final Grade Senior Level Coursework AP/IB/DC Credit Hours Final Grade

STUDENT NAME: UTA ID: Page 3 IV. EMPLOYMENT, ACTIVITIES, SERVICE, AND AWARDS Employment, Internships, and Summer Activities: 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. Position/Job Title Employer Hrs per week # of weeks Start Date: End Date: 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. Organization/Activity Position(s) Held Description of Activity FR SO JR SR Community 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. Place of Service Description of Service Hrs per week # of weeks Start Date: End Date:

STUDENT NAME: UTA ID: Page 4 IV. EMPLOYMENT, ACTIVITIES, SERVICE AND AWARDS (continued) Awards, Special Honors, and Distinctions In order of importance to you, list up to six major awards, honors, or distinctions that you received both inside and outside of school during grades 9-12. Award/Distinction/Honor Description or Basis for Award or Sponsor of Award Level of Competition (school, local, state, national) FR SO JR SR V. COLLEGE PLANS Will you be the first in your family to graduate college? Why have you chosen to apply to The University of Texas at Arlington? List, in order of preference, the top six colleges or universities you are considering attending (be sure to rank The University of Texas at Arlington among your choices): 1. 4. 2. 3. What have you chosen as your academic major(s)? Why have you chosen your academic major(s)? 5. 6. Briefly describe any educational plans you have beyond earning your bachelor s degree. What are some of your life s goals and objectives?

STUDENT NAME: UTA ID: Page 5 VI. FINANCIAL INFORMATION All Terry Foundation Scholarship applicants must complete a Free Application for Federal Student Aid (FAFSA) and select The University of Texas at Arlington (school code: 003656) to receive the information. FAFSA forms are submitted online annually October 1 st at www.fafsa.gov. File your FAFSA before March 15th. Financial information may be subject to verification from tax returns. Please complete all questions or your application cannot be considered. Student Information: Student s marital status: Student's total 2017 income: $ Student presently lives with (name & relationship to student): Parent/Guardian Information: (Answers should be for the parent(s) and/or guardian(s) who support the student at least 50%.) Parent/Guardian #1's name: Parent/Guardian #1's relation to student: Parent's marital status: Occupation: Employer: Age: Highest level of education achieved: Annual 2017 income: $ Parent/Guardian #2 s name: Parent/Guardian #2 s relation to student: Occupation: Employer: Age: Highest level of education achieved: Annual 2017 income: $ Are you (or your family) receiving financial assistance (such as Social Security disability) from any local or federal government entity? If yes, please indicate the type of assistance and amount received per month: Type of assistance received: Amount received per month: $ Value of your parents or guardians other investments (NOT including home): Net Value $ Value of your parents or guardians businesses, farms and/or ranches: $ Parents or Guardians Adjusted Gross Income for 2017 (from Form 1040/1040A): $ Was your family s 2017 income the same as it was for 2016? If no, did it increase/decrease? Est. amount changed? $ Please provide the information for all children less than 25 years of age in your household. Do not include yourself or your parents. Name Age Relationship School/College Year in College Self-Supporting? Yes Number of family members attending college during 2018-19 (including yourself):

STUDENT NAME: UTA ID: Page 6 College Savings Information: Funds for college saved by you: $ Funds for college saved by others: $ Do you have a Texas Tomorrow Fund or 529 college savings plan? What is the plan s value? $ Projected parental support for your college expenses (annual amount): $ Your parents or guardians total cash savings (not limited to college): $ Describe special circumstances affecting your family s ability to fund your college expenses (response required): VII. SCHOLARSHIP INFORMATION Please refer to the Financial Aid and Scholarships website for more information about the scholarship opportunities available at UT Arlington (uta.edu/scholarships). Please indicate any college or departmental scholarships specific to your intended major for which you are applying: List other scholarships for which you have applied for at The University of Texas at Arlington the 2018-19 academic year: Scholarship or Grant Name Duration of Award (1 year or # of years) Amount per year List other scholarships you will receive at The University of Texas at Arlington for the 2018-19 academic year: Scholarship or Grant Name Duration of Award (1 year or # of years) Amount per year

STUDENT NAME: UTA ID: Page 7 VIII. ESSAYS For BOTH of the topics listed below, type your answer in the space provided. Essays not typed in the space provided will not be reviewed. You will submit 2 essays total. Essay I: Significant Event and its Impact In approximately 500 words, answer the following: 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.

STUDENT NAME: UTA ID: Page 8 Essay II: 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. Print and sign your application. Applications without a signature and all required additional documents will not be considered. Applications and all required documents must be received by February 6, 2018.