EmailMe Form - LHU Foundation Scholarship

Student ID# *

Student Name *

First Last

Contact Information

LHU Email Address *

Campus Attending *

Main

Clearfield

Local Address at LHU *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Academic Information

Academic Major *

Academic Term *

Senior

Junior

Sophmore

Freshman

Scholarship Information

Please select the scholarship(s) for which you are applying: *

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Please describe how you meet the criteria for the specific scholarship you are applying.

In 150 words or less, please describe your career objectives (both short-term and long-term).

Please describe activities which you have participated in and contributions you have made as a student at Lock Haven University. (You may include both university-related and community-related).

Guest and Award Information

Name of Hometown Newspaper

Guest Names

Should you receive an award, your parents, spouse, guardian or other guest (up to 2) will be invited to the Spring Convocation. Please provide complete information so that a letter can be properly addressed.

Guest 1 Name

First Last

Guest 1 Address

Street Address City State / Province / Region Postal / Zip Code Country / Region

Guest 2 Name

First Last

Guest 2 Address

Street Address City State / Province / Region Postal / Zip Code Country / Region

Student Signature

By providing your signature below, you certify that the information on this applicaion is true and correct. In addition, you authorize Lock Haven University to release/provide academic and financial need information to the LHU Foundation Scholarship Committee for the purpose of determining my eligibility for Foundation scholarships.

Signature *

Clear