Student Scholarship Application Form

 First Name:*
 Middle Init.:
 Last Name:*
Address, line 1: *     
Address, line 2:     
City: *     
State & Zip:*
  Zip:
Home Phone:* 
Cell Phone:
E-mail Address: *     
High School Graduation Year: 
Name of College:* 
College Street Address:* 
College City:* 
College State & Zip:* 
  Zip:

Creative Work:
List any communications-oriented projects in which you have been involved during the last four years. These might include video tapes for cable access channels, motion picture films, photographic portfolios, written articles or essays, musical compositions or arrangements, graphic displays, or any other creative work. List awards or honors that relate to your creative work. DO NOT SEND TAPES.
Project One Name: 
Project Two Name: 
Project Three Name: 
Project Four Name: 
Other Projects: Please list any other projects you participated in, and your role in those projects.
Field Work and Experiences: Below please list internships, field experiences, job experiences, and/or community service in which you have participated during the last four years.
School Activities: List all activities and/or organizations in which you have participated while in high school. Include any offices you may have held, school-related honors you may have received and any other information you may consider relevant.
Test Scores: List SAT and ACT scores. Please indicate which test, date taken, and all scores. If you have taken the same test more than once, you may choose to list the single test and date when you received your highest scores. You may not list a verbal score from one test and a math score from a different test.
SAT Test Scores: 
Date Taken:
Math: Reading:
Writing:  
ACT Test Scores: 
Date Taken:
Math: Science:
Reading: English:
GPA: 
GPA Based on 4 Point Scale?: 
If GPA is not based on a 4 point scale, please explain below:

Career Aspirations Essay:
Below please submit a single-page essay that describes your interest in communication and broadcasting. How did you become interested in the field? What do you see yourself doing ten years from now in the communications field? The essay should be no more than 600 words in length (you can monitor your word count to the bottom left of the editor). You can also paste text directly from Word by clicking the Paste From Word icon (middle row toolbar, 5th icon from the left).
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