Florida State University Undergraduate Accounting Scholarship $500 Accounting Scholarship Awards To be paid in the Fall 2016 Semester

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1 Please type or print (in ink) all information. Florida State University Undergraduate Accounting Scholarship $500 Accounting Scholarship Awards To be paid in the Fall 2016 Semester 1. Please print your name and FSU Employee Number. Make sure that you complete the entire application. As the committee may require additional information on a timely basis, make sure the contact information provided below is current and accurate and updated with the Accounting Department, as necessary. If the committee is unable to contact an applicant or the applicant does not respond in a timely fashion, it may result in the applicant not being considered for an award. In addition, incomplete or inaccurate applications may result in the candidate not being considered for an award. 2. What is your current mailing address while at FSU? What is your permanent mailing address? 3. What is your current telephone number? (Please include area code, if not 850) 4. What is your current address? 5. Scholarship letters will be sent in May/June. What address would you like the letter to be sent to in order for you to be able to respond on a timely basis? Students enrolled in 12 or more hours in the Fall 2016 will receive a full scholarship, while students enrolled in 6-11 hours in the Fall 2016 will receive a 50% scholarship. Students not enrolled for at least 6 hours in the Fall 2016 will not receive a scholarship. If any of the contact information (e.g., mailing address) you supplied changes, please notify Mr. Alan Verdecia at that time. Failure to update contact information (e.g., mailing address) may result in the applicant not receiving a scholarship. Thus, if after you submit an application, your contact information (e.g., mailing address) changes, provide the updated information to Mr. Verdecia (his contact information is listed later in the application). 6. When do you expect to graduate from the undergraduate program?

2 7. Do you intend to complete the 150 hour requirement for CPA Licensure in Florida? If yes, how do you expect to satisfy the 150 hour requirement? If yes, when will you complete the 150 hour requirement? 8. List any past semesters that you received one of the above scholarships, i.e., the semester (s) in which you received the funds. 9. For the Spring of 2016, list the required accounting major classes (i.e., ACG and /or TAX), if any, that you are enrolled in. Course Title Instructor 10. For the Fall of 2015, list the required accounting major classes (i.e., ACG and /or TAX), if any, that you completed and the grade earned. Course Title Instructor Grade 11. For the Summer of 2015, list the required accounting major classes (i.e., ACG and /or TAX), if any, that you completed and the grade earned. Course Title Instructor Grade

3 12. Briefly describe your professional plans upon receiving your degree(s). 13. Please briefly describe your most important activity or honor since entering college and its significance. Do not just list honors and activities. 14. Given the limited resources available for these scholarships, the scholarship is intended to assist those students who are deserving and for whom the scholarship funds would fulfill a need. Briefly explain how your receipt of this scholarship would satisfy those objectives.

4 15. Please complete the information below concerning your accounting coursework that you have completed as of the Fall of 2015 and/or are enrolled in during the Spring of 2016, if any. For those courses not completed as of the date the application is submitted do not list a grade, specify N/A. Accounting Coursework Course Title Instructor ACG 2021 Intro to Fin Actg ACG 2071 Intro to Mgrl Actg ACG 3101* Fin Actg & Rep I ACG 3111* Fin Actg & Rep II ACG 3341* Cost I ACG 4201* Fin Actg & Rep III ACG 4401* Systems ACG 4501 Not-for-Profit ACG 4632* Audit I ACG 4642 Audit II TAX 4001* Tax I TAX 4011* Tax II Other Term Taken (Semester/Year) Grade *Accounting GPA Overall FSU GPA Total FSU Hours (8 upper level required ACG and TAX courses only) Overall GPA at other institutions Total hours at other institutions Anticipated Graduation Date Attach transcript(s), unofficial is fine. Return to the Accounting Department Office (Room 309) by 3:00 P.M. by Friday, April 22, The form may be returned in person or by mail. The mailing address is shown below. Mr. Alan Verdecia College of Business, Dept. of Accounting Florida State University P.O. Box Tallahassee, Florida Questions? Please check with Mr. Verdecia in the Accounting Office, telephone: Please read the following statements on the next page carefully and sign below indicating your agreement to the terms of the Accounting Department Scholarship Program.

5 If any of the contact information (e.g., mailing address) I supplied changes, I understand that I must supply the revised information to Mr. Verdecia in the Accounting Department Office (his contact information is provided at the end the application form) at that time. I understand that to be eligible for a scholarship I must have completed or be enrolled in one of the 8 required accounting major classes since the last time that I received one of these scholarships. For example, if the most recent scholarship that you received was in the Fall of 2015, you must have completed a class in the Fall of 2015 or be enrolled in a class in the Spring of In addition, I must have at least one upper-level (i.e., 3000 and/or 4000 level) required accounting major course (i.e., ACG and/or TAX) remaining to complete in the Fall 2016 Semester or later. Students enrolled in 12 or more hours in the Fall of 2016 will receive a full scholarship, while students enrolled in 6-11 hours in the spring will receive a 50% scholarship. Students not enrolled for at least 6 hours in the Fall of 2016 will not receive a scholarship. I grant the Accounting department permission to review my academic records and performance, as well as this application. I understand that if I receive a scholarship: (1) I will be notified via the contact information (e.g., mailing address) provided in this application, and it is my responsibility to check for notification. (2) Pursuant to Florida State University policies, I must provide the Accounting Department a thank you letter addressed to the donor/sponsor as indicated in the letter of notification (the letter sent by the Accounting Department to a scholarship award recipient after the scholarship decisions have been made) by the date specified. (3) I must be registered for classes as an accounting major at FSU during the Fall 2016 Semester. (4) The scholarship award will be disbursed by the Florida State University Financial Aid Office through the financial aid distribution during the Fall 2016 Semester. In no case will funds be paid after the Fall 2016 Semester. (5) The names of the scholarship award winners may be publicized, including but not limited to posting the names of the award winners on the Accounting Department webpage. (6) Pursuant to the College of Business policies, scholarship recipients are expected to attend the 2016 Leadership & Scholarship Dinner in the Fall 2016 Semester, barring unavoidable circumstances (e.g., a class scheduled at that time). Invitations (including the date and time) will be sent by the Dean s Office of the College of Business. (7) Pursuant to the Department of Accounting policies, scholarship recipients are expected to attend the 2017 Beta Alpha Psi Banquet in the Spring 2017 Semester, barring unavoidable circumstances (e.g., a class scheduled at that time). Invitations (including the date and time) will be sent by the Accounting Department Office. I have provided all of the required information, e.g., transcripts, and meet the eligibility requirements, e.g., minimum GPA. The information that I have provided in this application is true and complete. I have read the agreement concerning the terms of the Accounting Department Scholarship Program and agree to comply with the terms. Signature Date Please return to Accounting Department Office (Room 309) by 3:00 p.m. by Friday, April 22, A mailing address is also provided earlier in the application.

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