COVER SHEET FOR: The LEARN Wichita Adult Scholarship for Fall 2018 Application Deadline: July 1st, 2018

Type or print legibly. For US citizens and permanent residents only. All applicants must meet requirements.

STEP 1. SCHOLARSHIP REQUIREMENTS • Student must be 21 years of age or older. • Student must be a resident. • Student must be a US citizen or permanent resident. • Student may be a current student or new student to the school they wish to attend. • Student must NOT be currently receiving 100% financial assistance. • Student must submit a one-page, typed essay that answers the following question: “Why return to school as an adult student?” In addition to answering this question, please include your long range goals and financial needs.

STEP 2. EMPLOYMENT AND EDUCATIONAL INFORMATION

Which school do you plan to attend? ______Are you a current student? □ yes □ no (Participating schools are listed on the back)

Student ID:______Degree Program: ______How many credit hours completed? ______

Are you currently employed? □ yes □ no If yes, who is your employer? ______

Do you receive either of the following forms of tuition assistance (please check all that apply and list the percentage for each):

_____Employer reimbursement _____At what percent (50%, 80%, etc.)

_____Military TA, Post 9/11, VA benefits _____At what percent (50%, 80%, etc.)

Do you currently receive 100% tuition assistance from one or more sources? ___Yes ___No

STEP 3. APPLICANT INFORMATION

Legal Last Name First Name MI Other name(s) used on records

Mailing Address City ST Zip Code

______/_____/______Home Address (if different from mailing address) Date of Birth

Phone Number (including area code) E-mail address

Are you a Kansas State Resident? □ yes □ no Are you a US citizen or permanent resident? □ yes □ no STEP 4. Send Completed Scholarship Application and Essay to:

LEARN Adult Scholarship P.O. Box 3774 Wichita, KS 67201

Note: Email applications are not accepted. Applications must be received in the LEARN post office box noted above no later than July 1 of every year.

The following is a list of the schools/organizations participating in the LEARN Scholarship:

Baker University Butler Community College National American University

Cowley College Newman University Embry-Riddle Aeronautical University Southwestern College Professional Studies Ft. Hays State University Hutchinson Community College Wichita Area Technical College

The LEARN Scholarship Committee reserves the full right to deem an application incomplete or unqualified, and with the approval of the LEARN Board, to determine scholarship award amounts and the number of recipients each year. LEARN scholarships will be dispersed to the participating member institution of the recipient’s choice. The recipient (s) of the LEARN Scholarship must register for either the next consecutive enrollment date after July 20, 20 17 or prior to June 30, 2018. For questions, please contact Chad Shade, LEARN Chair, [email protected] .