Applicant Information Student name: Student id: County: Permanent address: Permanent city: Permanent state: Permanent zip: Email: Alternate email: Cell phone: Home phone: Birth date: Gender: Race or ethnic background: Citizenship: If permanent resident: Texas resident: References Reference 1 name: Reference 1 institution: Reference 1 mailing address: Reference 1 phone number: Reference 1 email: Reference 2 name: Reference 2 institution: Reference 2 mailing address: Reference 2 phone number: Reference 2 email: Educational Data Name of high school: City of high school: Intended major: Name of high school counselor: Email of high school counselor: Phone number of high school counselor: High school gpa: Scale: Graduation date: Class rank: Out of: Number tied for this rank:
PSAT Verbal: Math: Writing skills: Selection index: Date of test: SAT Critical reading: Math: Writing: Composite: Date of test: ACT Composite: Date of test: Indicate the level of recognition you have achieved in the following scholarship compeition(s). National merit: Date of national merit: National achievement: Date of national achievement: National hispanic: Date of national hispanic: Have you applied for admission to the honors college at unt: Have you been accepted for membership in the honors college at unt: Sophomore Level Coursework
Junior Level Coursework Senior Level Coursework
Employment, Activities, Service, and Awards Jobs
Orginizations and Activites
Service
Awards College Plans Will you be the first in your family to graduate college: Why have you chosen to apply to the university of north texas: 1: 2: 3: 4: 5: 6: What is our intended academic major: Why have you chosen your academic major:
Briefly describe any academic plans beyond earning your bachelors degree: What are some of your lifes goals and objectives: Have you ever been married: Students total income: Student presently lives with: Relation to student: Marital status: Annual salary: Occupation: Highest level of education achieved: 2013 income: Relation to student: Marital status: Annual salary: Occupation: Highest level of education achieved: 2013 income: Are you or your family receiving financial assistance such as social security from any local or federal government entity: Assistance Received Assistance 1 type: Assistance 1 amount: Assistance 2 type: Assistance 2 amount: Assistance 3 type: Assistance 3 amount: Value or your parents guardians other investments not including home: Value or your parents guardians businesses farms and or ranches not including home: Parents or guardians adjusted gross income for 2013 from form 1040 1040a: Was your familys 2013 income the same as it was for 2012: Did it increase or decrease: Estimated amount of change: Please provide the information for all children less than 25 years of age in your household.
Child 1 Child 2 Child 3 Child 4 Child 5
Child 6 Number attending college in 2013 2014 including yourself: Funds for college saved by you: Funds for college saved by others: Do you have a texas tomorrow fund or 529 college savings plan: What is the plans value: Projected parental support for your college expenses annual amount: Parents guardians total cash savings not limited to college: Please describe any additional factors or circumstances demonstrating your financial need: List other scholarships for which you have applied a the University of North Texas for the 2014-2015 academic year List other scholarships for which receive at the University of North Texas for the 2014-2015 academic year
Powered by TCPDF (www.tcpdf.org) Essays Essay 1 significant event and its impact: Essay 2 leadership experience: Digital signature: