ASU Phi Theta Kappa Scholarship Awards. General Information

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1 ASU Phi Theta Kappa Scholarship Awards General Information Arizona State University has established a scholarship to make multiple awards of $2,000 ($1,000 per semester) available for the academic year. Awards will be based on current and good standing membership of Phi Theta Kappa International Honor Society and competitive GPA (ASU calculated transfer GPA). Preference will be given to students who have earned an associate degree. Eligibility Applicant must: Be a U.S. citizen or permanent U.S. resident Be newly admitted to ASU for fall 2011 and enrolled as a full time undergraduate (at least 12 credit hours) in the fall 2011 and spring 2012 semesters. Applicants must also be enrolled in an initial baccalaureate degree at the Tempe, Polytechnic, West or Downtown Phoenix campus. Online degree seeking students are not eligible Have a minimum 3.5 cumulative transfer GPA (as calculated by ASU) Current and good standing membership in Phi Theta Kappa International Honor Society Students are eligible to receive one institutional merit award (i.e. Alliance Merit, New American University Transfer Merit, etc) In the event you become qualified for a another merit award, ASU will apply the award with the highest dollar value. Submitting your Application (Faxes not accepted) Mail or Deliver in person to: Matthew Engel Director, Transfer Admissions Undergraduate Admissions PO Box Tempe, AZ Deadline Application deadline is 5:00 p.m., Friday, April 29, Application forms and all supporting documents must be received by this deadline. Applications received after the deadline or applications that are incomplete at the deadline will not be considered. Please note: the deadline is NOT a postmarked deadline. Faxes are not accepted. Notification and Disbursement Scholarship recipients will be notified of their award via mail by early June, Students will receive two equal payments of $1,000 each that will be applied toward tuition and fees for the fall 2011 and spring 2012 semesters. Scholarship recipients must maintain continuous eligibility to receive the spring 2012 semester disbursement (including but not limited to an ASU 3.25 cumulative GPA, full-time status, and enrollment in an initial baccalaureate degree).

2 Application Procedure The complete application package must contain the following: Completed scholarship application (page 3 of application form) Official community college and *high school transcripts on file with ASU s Undergraduate Admissions office. *Only if ASU requires official high school transcripts to be admitted. Basic Terms & Conditions I give my permission for the release of academic, financial, and/or necessary information requested by the appropriate scholarship selection committee. Further, if a scholarship is awarded to me, my consent is hereby given for the release of academic, financial, or other necessary information requested by the scholarship donor that may be used for the purpose of monitoring academic progress I understand that the information throughout this application is accurate, and I understand that misrepresentation of any facts or details could result in ineligibility I meet all the eligibility requirements listed on page 1 on or before April 29, 2011 I understand the scholarship will be revoked if I no longer meet the eligibility criteria I confirm by signature that the information I have provided is accurate and true to the best of my knowledge, and I give the committee permission to contact my school(s) for verification of this information. I understand that the scholarships are awarded at the discretion of the Scholarship Committee Signature: Date: Note: All documents become the property of ASU Phi Theta Kappa Scholarship Committee. *Disclosure of your Social Security Number is optional. If you are awarded a scholarship, you will need to provide you Social Security Number for tax purposes.

3 The ASU Phi Theta Kappa Scholarship Application Please check one: Applied to ASU Admitted to ASU Please check one: Arizona Resident Nonresident (determined by the Residency Classification Office) Please check one: I am/will be attending: Downtown Phoenix campus Polytechnic campus Tempe campus West campus The following information MUST be filled out completely: (please print clearly & ensure accurate address for notification) Name (Last, First, Middle Initial) ASU ID (10 Digits) Permanent Mailing Address (No., Street, Apt.) City, State, ZIP Phone Number with Area Code Are you a U.S. citizen or a permanent U.S. resident? Yes No Date of Birth / / Current College Attending (Name, City, State) Dates Attended/Credits Completed Phi Theta Kappa ID# Phi Theta Kappa Chapter Degree(s) Received Cumulative GPA Earned Intended or Current Course of Study/Major Anticipated Graduation Date Prior/Returning Phi Theta Kappa Scholar Recipient # of hours enrolled/anticipated fall 2011: anticipated spring 2012 hours:

4 Consent to Release Records The federal Family Educational Rights and Privacy Act (FERPA) protects the privacy of educational records that the university maintains about me. By signing below, I give permission for Arizona State University to disclose to the donor and any review committee the information provided in connection with this scholarship application for the purpose of the review of my application, and the administration and promotion of the scholarship program. This may include information from my educational records, such as my official transcript, letters of recommendation, and financial aid information. This permission is granted for each semester I am awarded a scholarship from the Arizona State University Phi Theta Kappa Scholarship Committee. Student Name Anticipated Graduation Date for Current Degree Student Signature Date

5 CHECKLIST FOR ASU PHI THETA KAPPA SCHOLARSHIP APPLICATION MEET ALL ELIGIBILITY REQUIREMENTS (PAGE 1 OF APPLICATION) SIGNATURE ON BASIC TERMS AND CONDITIONS (PAGE 2 OF APPLICATION) COMPLETED SCHOLARSHIP APPLICATION FORM (PAGE 3 OF APPLICATION) COMPLETE APPLICATION MATERIALS MUST BE RECEIVED BY APRIL 29, 2011 (THIS IS NOT A POSTMARKED DEADLINE) SIGNED RELEASE FORM QUESTIONS? FOR QUESTIONS OR CLARIFICATION REGARDING ANY ASPECT OF THE APPLICATION PLEASE CONTACT: Matthew Engel Matthew.Engel@asu.edu FOR QUESTIONS REGARDING TRANSCRIPTS ON FILE, PLEASE CALL: ASU Undergraduate Admissions , option #5 FOR QUESTIONS REGARDING FAFSFA OR FINANCIAL AID PLEASE CALL: ASU Financial Aid Office INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.