MGB Scholarship Application - School Form - Summer Laureate University for Youth

In collaboration with the family of Martha Gaunt Bass and the UA Little Rock Center for Gifted Education, the Office of Development has established an endowed scholarship for a child attending SLUFY.

This part of the application is to be filled out by school personnel and is the place to upload the other documents required.

Student Name(Required)

First Last

Parent Name(Required)

First Last

School Name(Required)

District Name(Required)

Principal's Name(Required)

GT Facilitator's Name(Required)

Referrer's Name(Required)

Referrer's Position(Required)

Referrer's Phone(Required)

Referrer's relationship to student(Required)

Upload required documents – see list below.(Required)

Required Documents: □ Documentation of high academic ability (i.e. test scores, grades, etc). □ Documentation from school’s counselor or administrator that the student participates in National School Lunch or Breakfast program □ Letter of recommendation from teacher, GT teacher, principal, or counselor on why student needs a financial and academic scholarship

Drop files here or

Accepted file types: pdf, docx, jpg, png, Max. file size: 24 MB, Max. files: 5.

Referrers Signature and date(Required)

Typing your name and the date into this field constitutes your signature.

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