Annaliese Bischoff Honors Scholarship Application

Office Use Only Date Received: Cum: Grad year:

Commonwealth Honors College Room 301 University of Massachusetts, 157 Commonwealth Ave., Amherst, MA 01003-9253 Phone 413.545.2483/ Fax413.577.2620 [email protected] www.honors.umass.edu

Annaliese Bischoff Honors Scholarship Application University of Massachusetts Amherst Commonwealth Honors College students who are pursuing creative endeavors in the arts and humanities or in social sciences are eligible to apply for the Annaliese Bischoff Honors Scholarship. Preference will be given to first generation college students and/or those with financial need as determined by the Financial Aid Office. This scholarship was endowed by a long time UMass Amherst and Commonwealth Honors College Professor and consists of a one-time award that is applied directly toward the student’s tuition and fees. Selection is based on a combination of financial need and academic achievement. The amount of the scholarship varies from year to year depending on endowment earnings. In 2017 the award will be approximately $1,000 and will be applied to the recipient’s Fall 2017/Spring 2018 tuition and fees. To apply, students must submit an “Annaliese Bischoff Honors Scholarship Application” accompanied by a typed one-page essay discussing their educational and career goals and how a scholarship will help them achieve those goals. The application deadline is Monday, February 27, 2017, 5:00 p.m. to the Commonwealth Honors College office, Room 301, Amherst, MA 01003-9253.

The awards will be announced in early April and recipients will be invited to the Commonwealth Honors College spring awards ceremony scheduled for April 29, 2017.

Complete and sign the application form. Form should be completed electronically. Information may be continued on additional sheets if necessary.

Student ID Email Date of Birth (MM/DD/YY)

Name (last) (First) (Middle)

Local Address Line 1 Address Line2

City State Zip Phone

Home Address Line 1 Address Line2

City State Zip Phone

Residency (check one) US Citizen Resident Visa

Number of semesters completed at UMass: Expected Grad Date:

UMass Major (1) CHC Departmental Honors UMass Major (2) CHC Departmental Honors UMass Minor GPA

University Activities:

Commonwealth Honors College Activities:

Community and Public Service Activities:

Other University awards, prizes or recognitions:

Employment and Financial Aid Information:

Are you employed during the school year? Yes No If yes, how many hours a week on average do you work? Employer’s name and address:

What amount did you personally (out of pocket) contribute toward college expenses $ this year? Last academic year’s contribution? $ Did you file a FAFSA for the next school year? Yes No If not, why? Are you receiving financial aid this year Yes No Amount received in loans? $ Amount received in Grants/Waivers? $ Total amount of indebtedness to date ($): $ Did you receive a scholarship in previous years? Yes No If yes, list all scholarships received:

Total scholarship amount: $

On a separate sheet of paper submit a typed one-page essay discussing your educational and career goals and how a scholarship will help you reach your goals.

I, , the applicant, hereby sign this form and state that all information supplied in conjunction with this application is correct and true.

Signature of applicant: Date:

Annaliese Bischoff Honors Scholarship Application Form revised 11/15