Taking Applications!
Criteria For Applicant
Applicant has to have been diagnosed with Ulcerative Colitis
Must maintain a GPA of at least 2.5
Must be enrolling or enrolled in a school/university
Scholarship will be directly paid to the school/university
Must maintain a GPA of at least 2.5
Must be enrolling or enrolled in a school/university
Scholarship will be directly paid to the school/university
Information
We will be able to provide (1) one $500.00 scholarships. You will need to send in the application below along with supporting documentation from your GI doctor. Also required is a short essay (1 page or less) on your future goals and how Ulcerative Colitis has affected your life. The recipient will be notified by telephone. Submit application to: UCFA, 11106 Birdwood Lane, Corpus Christi, TX 78410
ULCERATIVE COLITIS FOUNDATION OF AMERICA
SCHOLARSHIP APPLICATION
BIOGRAPHICAL INFORMATION
NAME: (First) _______________________ (Middle) _____________________
(Last) __________________
DOB: _____________________________
ADDRESS: ____________________________________________________________________________
City _____________________________
State _______________________________
Zip ________________
TELEPHONE: ___________________________________
PARENT EMPLOYED BY: _______________________
NAME OF PARENT: __________________________________
TELEPHONE: ________________________
POSITION: __________________________
COLLEGE TO BE ATTENDED: _________________________________
LOCATION: _________________
DATE DIAGNOSED WITH ULCERATIVE COLTIS:_________________________
EDUCATIONAL BACKGROUND
HIGH SCHOOL: ____________________________
LOCATION: __________________________________
DATE OF HIGH SCHOOL GRADUATION: _____________________________
HIGH SCHOOL CUMULATIVE GPA: _________________________
On a scale of: ___________________
RANK IN CLASS: __________________ Out of how many? ____________________
SAT Results: V _________ M _________ W _________ TOTAL: _________ and/or
ACT: _____________
HONORS/AWARDS: (PLEASE be specific—do not state “refer to resume”)
ACADEMIC HONORS
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
ACTIVITIES/SPORTS HONORS
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
OTHER NOTEWORTHY HONORS
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
SPECIAL CONSIDERATION (can include some of the following: death of a student’s parent or guardian; disability of student; other unusual expenses or circumstances)
____________________________________________________________________________
____________________________________________________________________________