University of CincinnatiCollege of Nursing
Scholarship Application

Applications must be submitted electronically by 5:00 PM on Wednesday, May 16, 2008.

* Indicates required field.

UC M- ID or Person Number*

    
Last Name*
 First Name*
 Middle Initial
Mailing Address*
  
City*
 State*
 Zip*
Country
 E-mail Address*
  
Telephone (Day)*
 Telephone (Evening)
  
What is your University GPA?*  
Enrollment Status for Autumn 2008*  
Academic Program for Autumn 2008*  
I have applied for Federal Financial Aid (FAFSA)?*
(To demonstrate financial need, applicants must have applied for FAFSA, although applicants do not have to receive financial support from this program.)		  
Are you a resident of Darke County, Ohio?*  
Are you, or have you been an EMT or firefighter, or are you the child of an EMT or firefighter?*  
If YES, please explain.
Define your academic and career goals.
Explain why financial assistance is required. (For Alfred Heil Scholarship, please detail Italian-American heritage in box below.)
List any extracurricular activities in which you are involved.
List any honors you received in high school/college.

First/Last Name*
Please make sure all information is accurate before submitting application.