Scholarship Application

Click here for a PDF of the 2019 Scholarship App

2019-2020 SCHOLARSHIP APPLICATION FORM
(Applications must be completed in full and postmarked by Friday, February 22, 2019)
Name: ___________________________________________________ Telephone: _________________________ PLEASE PRINT OR TYPE
Permanent Mailing
Address: _____________________________________________________________________________________
Street City State Zip
Social Security number (last four digits only) ___________ Email Address_______________________________
(Personal, not school related)
As a self-supporting applicant:
Annual Family Income: ______________________ Number of Dependents: ________________________
OR You are a dependent:
Father’s Name: ____________________________________________________________________________________
Mother’s Name: ___________________________________________________________________________________
Number of Dependent Children (including Applicant): ____________ Annual Family Income: $ ________________
Are any other members of your family in college? __________ If so, how many? _______________________
Last High School or College Attended: _________________________________Cumulative GPA: ____________
Which New Mexico institution do you plan to attend? _________________________________________________
Address: ______________________________________________________________________________
______________________________________________________________________________________
Department: ____________________________________________ Telephone: (_____) ______________
Which field do you plan to major in? ______________________________________________________________
Have you applied for entrance? ___________________ Have you been accepted? _________________
Total education expenses expected for year: $ _______________________________________________
Amounts received from any other scholarships/grants: $ ______________________________________
In the space below, please tell us about your academic honors, social and community activities, and your work experience:
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
(OVER)
In a 100-word essay, address the issue of how this scholarship will assist you in meeting your academic goals. ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
NOTE: PLEASE READ THE AGREEMENT BELOW AND SUPPLY ALL ADDITIONAL INFORMATION REQUESTED BEFORE SIGNING
 I give permission to review this application and my school records to anyone representing the scholarship donors.
 I have submitted a copy of my recent transcript.
 I have enclosed one letter of recommendation.
 Should I receive this scholarship, I agree to my name and photograph being released for publication in this regard.
 I understand that I must have a cumulative 2.8 GPA on a 4.0 scale, must be enrolled as a full-time student (no less than 12 credit hours) and be a New Mexico resident (NM state residency requirement is 1 year) to be eligible for the scholarship. Only undergraduate students are eligible. The scholarship must be used to attend an accredited vocational, technical school, college or university in New Mexico.
Signature of Applicant Date
Signature of Parent/Guardian (if you are a minor) Date
Mail completed scholarship application and attachments to: NM CU Education Foundation, 4200 Wolcott Ave. NE, Albuquerque, NM 87109
Scholarships hand delivered will not be accepted.
Applications must be completed in full and postmarked by Friday, February 22, 2019