City, State, Zip Code:
Year in School:
Married or Single Parent:
Ages of Children:
Name of High School:
Please list other Education/Training:
List activities in which you have participated or other ways in which you may have been of service (college, community, children's school, etc). You may also include honors, awards, scholarships and/or positions of leadership.
List any exceptional financial needs and explain why you are applying for this scholarship.
Write a paragraph of 200-300 words outlining your academic and career goals and how this degree will benefit you in attaining them.
Nontraditional Student Services • Schofield Hall 226 • University of Wisconsin-Eau Claire • Eau Claire WI 54702-4004
Phone: 715-836-3259Questions/Comments: firstname.lastname@example.org Updated: August 26, 2010
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