2023 In-House Scholarship Application

Student Name*

First Middle Last

Student Number*

Year In School (Fall 2023)*

Email*

Phone*

Cumulative GPA*

Declared or Intended Major*

Years lived in / plan to live in Chapter House*

Parent Name*

First Last

Parent Email*

Scholarship Basis -- I am applying for a scholarship based on the following (select all that apply):*

Please descripe why you are applying for a scholarship based on the option(s) you selected above.*