APPLICATION PROCEDURE

Complete the online application by the final deadline October 5, 2007

       Title:  Mr. Ms.

       First Name:      Last Name:  

       UIN:    

       Expected Graduation Date:   Spring 2007 Summer 2007 Fall 2007 Spring 2008 Summer 2008 Fall 2008 Spring 2009 Summer 2009 Fall 2009 Spring 2010 Summer 2010 Fall 2010 Spring 2011 Summer 2011 Fall 2011 Spring 2012 Summer 2012 Fall 2012

       UIC E-mail Address:  

       Address:  

       City:      State:  

       Zip:  

       Telephone Number (Home):      (Area Code & Phone#)

       Are you currently receiving financial aid:     Yes          No

        . Receiving a scholarship may impact your campus-based financial aid
        and/or adjust your overall financial aid package. Consultation with the
        Financial Aid Office should be done prior to the distribution of any
        monetary award.

       Ethnic Background:  White (Non Hispanic) Black/African American (Non Hispanic)AsianNative AmericanLatino/Latina

        Mexican American     Puerto Rican     Other Specify   

       List any academic honors you have received:  
                           

       Extracurricular activities (explain your role in these):  
                           

        Scholarships or other financial aid for 2005 - 2006 
        academic year(be specific and state type of aid or
         scholarships and amount, please estimate if you don 't
        know exact amount):
                           

        Prepare a personal statement no longer than one page
        addressing how receiving a CBA scholarship would
        impact you financially and academically; discuss any
        financial hardships that you may have had and finally
        share information about your background that have
        contributed to your academic experience/success.

        The statement is one of the most important aspects
        of this application and is equivalent to an interview.  
                           

       Kindly copy/paste your resume here (plain text format):  
                           

        I certify that the information provided on this scholarship
        application as well as the supporting documents are
        accurate and official.

       Student Name:      

       Date:   Month:  JanuaryFeburaryMarchAprilMayJuneJulyAugustSeptember OctoberNovemberDecember   Day:  010203040506070809101112 1314151617181920 2122232425262728293031    Year:   20072008  

       

The information submitted above will be kept confidential

   If you have any problems submitting information please contact  aramas2@uic.edu