Wufoo

Scholarship Confirmation
I am applying for the scholarships selected below. Please select the scholarship(s) that you are applying for: *
Senior Class Legacy Alumni Endowed Scholarship Therese Whitcomb ‘53 Daniel L. Burkett III Memorial Kyle O’Connell Memorial
Essay Confirmation *
I have read and understand the scholarship criteria listed on the Alumni Association website and am submitting a copy of the required essay(s).
Name First Last
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email
Phone Number ### - ### - ####
USD Student ID# *
GPA (cumulative) *
Degree/Major/Minor *
Expected graduation (month and year): *
Current registered units (spring semester 2012) *
Class standing at the beginning of fall 2011 semester. Please select only one: *
Freshman (completed less than 30 units) Sophomore (completed 30 units or more) Junior (completed 60 units or more) Senior (completed 90 units or more) Graduate student Other (specify)
Planned number of units for Fall 2012: *
Planned number of units for Spring 2013: *
These scholarships are only available to returning USD students. Were you a USD student during the fall 2011 semester? *
Yes No
Therese Whitcomb ’53 and Alumni Endowed Scholarship Fund applicants only. If you have family relatives who attended or currently attend USD, please list their names and relationship to you here (Ex: Jane Smith, mother):
Therese Whitcomb ’53 Scholarship applicants only. If you transferred to USD from a different college or university, please list the name of the college or university here:
ON-CAMPUS ACTIVITIES - Please list any on-campus activities (i.e., clubs, organizations, athletics, volunteerism, etc.) that you have been involved in at USD. List organization name, dates of involvement and leadership positions. 150 word maximum. *
Maximum Allowed: 150 words. Currently Used: 0 words.
COMMUNITY SERVICE - Please list any community service (volunteerism, community involvement, etc.) you participated in while attending USD. List organization/project name, dates of involvement and role. 150 word maximum. *
Maximum Allowed: 150 words. Currently Used: 0 words.
HONORS AND AWARDS - Please list any honors/awards that you have received while attending USD. Include the date(s) received and a brief description. Do not include scholarship or financial aid information. 50 word maximum. *
Maximum Allowed: 50 words. Currently Used: 0 words.
Senior Class Legacy Scholarship applicants:

Please upload an essay (Word document only), containing 400-500 words, describing how you have left a legacy through your campus involvement that will impact future students at USD.
Alumni Endowed Scholarship Fund applicants:

Please upload an essay (Word document only), containing 750 words or less, about your demonstrated involvement and service to USD and/or the community and how you can use that involvement and service to stay engaged and involved with the University as an alumnus.
Therese Whitcomb ‘53 Scholarship applicants:

Please upload an essay (Word document only), containing 750 words or less, about your demonstrated involvement and service to USD and the community.
Daniel L. Burkett III Memorial Scholarship applicants:

Please upload an essay (Word document only), containing 750 words or less, about how you were able to benefit the life of somebody else through any personal life experiences, your involvement in USD Greek Life, and/or other campus involvement or community service.
Kyle O’Connell Memorial Scholarship applicants:

Essay #1: Please upload an essay (Word document only), containing 500 words or less, about why you chose your academic major.
Kyle O’Connell Memorial Scholarship applicants:

Essay #2: Please upload an essay (Word document only), containing 500 words or less, describing how you will use your education to do one or a combination of the following:
-Discover new treatments and/or improve current treatments and ultimately find a cure for cancer
-Provide comfort and hope for patients and their families who are struggling with terminal illness
-Become an advocate to motivate others to become active in the fight against this deadly disease.
I verify that all of the information provided on this application is both true and valid. I have read and understand the scholarship criteria and have uploaded a copy of the required essays.

Electronic signature (Insert first name, last name, date below): *
Do Not Fill This Out