Undergraduate Scholarship Application

Please take some time to fill out the scholarship application below. If you would prefer a hard copy, please follow the link for a PDF version of the application. If you choose to fill out a paper application, please send it to

University of Little Rock

ATTN: School of Mass Communication

2801 S. University Ave.

Stabler Hall 705

Little Rock, AR 72204

UALR School of Mass Communication Undergraduate Scholarship Application

Instructions: Please complete the entire application. If the application is incomplete, you may not be considered for a scholarship. Respond to each section as accurately as possible. The deadline for submitting this scholarship application is noon, MARCH 1, for the current academic year. For a list of available scholarships and scholarship requirements and specifications, see the UALR School of Mass Communication web site’s scholarships page.

Personal Information: Name*
First Middle Initial Last
T-Number (Start with "T")*
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Address (If different than mailing address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone (___) ___-____*
Email*
Specify minor, sequence, and expected graduation date*
Number of Credit Hours Completed*
Grade Point Average*
I am applying for the following scholarship(s)*
Scholarship recipients must attend the SMC Scholarship Award Luncheon in April. Will you attend?*
What should we say to the audience at that luncheon about you? Be brief and highlight your accomplishments.*
What are your professional goals? (This information might also be used at the luncheon.)*
List your media experience if any. (This information might also be used at the luncheon.)*
Give a brief description of community service activities, extracurricular activities, honors, achievements, and leadership positions (attach a separate sheet if necessary).*
Financial Information: Did you receive a scholarship from UALR last year?*
If so, name of scholarship(s).
Describe your financial need.*
Please list the amount of income earned in the last calendar year through: Your work (full or part-time)*
Please list the amount of income earned in the last calendar year through: Your spouse's work*
Please list the amount of income received in the last calendar year through: Your parents*
Other income that pertains to your educational expenses: Loan(s)*
If applicable, please specify
Other income that pertains to your educational expenses: Other grants/scholarships*
If applicable, please specify
Veteran's Benefits*
Other sources of income*
If applicable, please specify
Total
Name*
This will act as your signature
First Middle Initial Last
Date*
mm/dd/yyyy
Date Format: MM slash DD slash YYYY
Certification*
I certify that all information and statements I have provided on this application are true and correct to the best of my knowledge. Donors or agencies outside of UALR occasionally request information contained on this application. I permit the release of educational, personal, and financial information to the individual donors or outside agencies, to be considered for scholarships. I understand that an incomplete or falsified application may cause me to be disqualified.

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