Preview Student Application for 2015 Gates Millennium Scholars Program

Prefix

First Name * Middle Name Last Name *

Suffix

Social Security Number *

E-mail Address *

Date of Birth *

(mm/dd/yyyy)

PREVIEW STUDENT APPLICATION FOR 2015 GATES MILLENNIUM SCHOLARS PROGRAM(Not for submission)

Personal Information

Address Type * Country *

Address 1 * Address 2

Zip * City * State *

Address Type * Country *

Address 1 * Address 2

Zip * City * State *

Phone Type *

Country Code Phone * Ext

Phone Type *

Country Code Phone * Ext

Contact Information

Address

Address

Phone

Phone

GMS Ambassador College Fair Newspaper/Radio FastWeb Scholarship Search

School Friend GMS Representative Upward Bound/Talent Search

Other

How did you hear about this program?

Other Description

Ethnic Code * Ethnic Sub-group *

Residency Status * Country of Citizenship *

Which language(s) did you first learn? * Specify Non-English Language *

Gender *

Demographic Information

Essays

Essay 1

Discuss the subjects in which you excel or have excelled. To what factors do you attribute your success?

Essay 2

Discuss the subjects in which you have had difficulty. What factors do you believe contributed to your difficulties? How have you dealt with them so they will notcause problems for you again? In what areas have you experienced the greatest improvement? What problem areas remain?

Essay 3

Briefly describe a situation in which you felt that you or others were treated unfairly or were not given an opportunity you felt you deserved. Why do you think thishappened? How did you respond? Did the situation improve as a result of your response?

Essay 4

Discuss your short and long-term goals. Are some of them related? Which are priorities?

Essay 5

Discuss a leadership experience you have had in any area of your life: school, work, athletics, family, church, community, etc. How and why did you become aleader in this area? How did this experience influence your goals?

Essay 6

Discuss your involvement in and contributions to a community near your home, school or elsewhere. Please select an experience different from the one youdiscussed in the previous question, even if this experience also involved leadership. What did you accomplish? How did this experience influence your goals?

Essay 7

Other than through classes in school, in what areas (non-academic or academic) have you acquired knowledge or skills? How?

Essay 8

Is there anything else you would like to tell us about that may help us evaluate your nomination (i.e., personal characteristics, obstacles you have overcome)?

Essay 9

ONLY for Nominees who graduated from high school or earned their GED more than one year ago: Describe those activities in which you have participatedsince completing high school (e.g., community service, leadership, employment) that you believe qualify you for this scholarship.

First choice college/university to which you plan to apply

Institution (High School) Name *

Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)

Graduation Year Class Rank Class Size Cumulative GPA *


Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)



Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)


Were you absent from high school for one or more terms before graduating? *

Yes No

Please indicate reason(s) *

Education Information

Education

if (!(Model.QuestionConfigurations["201.HSGraduate"].QuestionFlag == QuestionFlags.Ignore)) {

I will or have graduated from high school by June of 2015, and will be a first-time entering freshman in the fall of 2015

Yes No

}

High School Details

High School Detail Record




Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)



Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)


GED Score * GED Date *

(mm/dd/yyyy)

Institution Name *



if (!(Model.QuestionConfigurations["201.EarnedGED"].QuestionFlag == QuestionFlags.Ignore)) {

Earned GED

Yes No

}

GED Details

if (!(Model.QuestionConfigurations["201.NoHSNoGED"].QuestionFlag == QuestionFlags.Ignore)) {

I have not graduated from high school nor completed the requirements for a GED diploma by June 2015, but I have been admitted to acollegiate institution

Yes No

}

College Details

Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)

Name of Organization *

Occupation or Title *

Description of Activities *

Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)




Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)


Leadership

Do you have any Leadership roles to list? *

Yes No

Please Explain Why *

Leadership Information





Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)




Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)




Begin Date *

(mm/dd/yyyy)

End Date *

(mm/dd/yyyy)







NoReasonDisplay

HonorsListDisplay

MaxHonors

8

HonorsMsg

DisplayHonorsMsg

Dates *


Total Number ofHours *


Dates *




Dates *

Community Service

Do you have any unpaid Volunteer Work or Community Service activities to list? *

Yes No

Please Explain Why *

Community Service Detail Information






Dates *




Dates *






Dates *

Employer *

Total Number of Hours *


Dates *

Employer *



Dates *

Employer *



Employment

Do you have any Paid Employment to list?

Yes No

Employment Information



Dates *

Employer *



Dates *

Employer *





Grade Level * Subject Area *

Provide Academic Record information by selecting the GradeLevel and SubjectArea.

Course Title *

Course Length * Honors Level *

Yes No

Letter Grade *



Course Title *


Yes No

Letter Grade *



Course Title *


Yes No

Letter Grade *



Math Level *

Highest-level full year of math already completed with a grade of 'C' or better:

Academic RecordProvide Academic Record Information in Subject areas of English, Other Languages, History, Social Science, Mathematics, Preparatory and/or AcademicElectives: Include Visual/Performing Arts, Social Science (Anthropology, Economics, Psychology, Sociology, etc.), Computer Science.

Academic Record Details




Course Title *


Yes No

Letter Grade *



Course Title *


Yes No

Letter Grade *


Choose either Dependent or Independent Student Status *

Dependent Independent

Family Size in 2014 * Gross Annual Income in 2014 (estimate if necessary), of yourself *

Number in College in 2015 *

Financial Aid Info

Authorization

Opt out of having your scholarship information shared with UNCF personnel for contact purposes?

Yes No

Allow elements of your profile to be updated from the submitted application?

Yes No

ESA VERSION 3.2.3.433© 2012-PRESENT, UNCF ADMINISTERED BY UNCF

This print out allows you to view components of the official form. Log onto the UNCF online application system, scholarships.uncf.org, for theeligibility criteria, the deadline, and to complete and submit your official form.

http://www.uncf.org/

https://scholarships.uncf.org/

Documents

Preview Student Application for 2015 Gates Millennium Scholars Program