Apply Online

Name
University Office and Address
Work Phone
Position
Years at N.U.
Home Address
Home Phone
E-mail Address
Marital Status
Number of Dependents
Do you prefer to be contacted
at home
at work
Where are you in terms of work on your program?
beginning
continuing
completing
Name of the program
Graduate Program
Undergraduate Program
Name of adviser
Adviser's Phone No.
Please list the courses completed in the program and the courses yet to complete (including hours or units)
When do you plan to complete your program?
This program awards a degree
degree
certificate
List previous degrees and the institution
What are your short-term career goals?
What are your long-term career goals?
How does the program you are working on relate to these goals?
Why are you applying for this scholarship and how would this award be helpful to you?
Are you eligible for financial aid from any other source?
Yes
No
If yes, what award?
Amount
Are there any restrictions which go with this award?
With your N.U. discount, how much do you pay per course?
The Scholarship Committee may wish to meet with you personally. Please indicate your time preference.
Noon
Afternoon
Early evening
Weekends
Other

Please attach a listing of your high school and post-high school educational background, beginning with the most current. Please attach an N.U. transcript if applicable.

Please attach information on professional experiences, awards, presentations, publications, and professional memberships, and any other material or information which you feel would be helpful to the Scholarship Committee.