2017-2018 Scholarship Application The Josiah N. Moore Memorial Scholarship is made possible by an Endowment at the ASU Foundation created by the family of Josiah N. Moore, former Chairman of the Tohono O odham Nation and English Professor at ASU. Administered by the ASU Native American Alumni Chapter, the scholarship was created to assist with the educational needs of American Indian students at ASU. The scholarship amounts awarded will be two (2) 2,000 scholarships, one for a current undergraduate student and one for a current graduate student. Two (2) 1000 scholarships will be awarded to the second place applicants. The amounts listed will be distributed in the Spring 2018 semester through ASU Financial Aid Office. SCHOLARSHIP CRITERIA: Must be enrolled in a federally recognized Indian tribe (must provide Certificate of Indian Blood/Enrollment number or Tribal ID). Open to undergraduate and graduate students. Undergraduate applicants: Must be enrolled full time with a minimum of 12 credit hours per semester at any of ASU s campuses or ASU Online. Minimum of 24 credit hours completed at ASU Cumulative ASU GPA of 3.0 or above. Must show financial need as determined by the ASU Financial Aid Office. Graduate applicants: Must be admitted to a graduate program. Must be enrolled full time with a minimum of 9 credit hours per semester at any of ASU s campuses or ASU Online. Must show financial need as determined by the ASU Financial Aid Office. APPLICATION PROCEDURE: 1. Complete the application form. 2. Submit a copy of Certificate of Indian Blood/Enrollment Number. 3. Provide one (1) letter of recommendation from a non-family member (advisors, counselors, faculty members, professors, etc). 4. Submit a personal goal statement 5. Submit financial information and need statement. 6. Submit copy of unofficial transcripts. ELIGIBILITY - Scholarship criteria must be met at time of application as well as during academic year specified on application. FULL-TIME - Carrying and completing 12 credit hours or more each semester for undergraduate applicants and 9 credit hours or more each semester for graduate applicants. REAPPLYING - Students must apply each year to be considered for renewal. *If selected, student awards will be in the Spring* DEADLINE Friday, September 29, 2017 by 5 pm to the address indicated below. Mailed submissions must be post marked by Wednesday, September 27, 2017 Submit complete application to: For questions contact: ASU Alumni Association Cheryl Begay-Mizell archaeo@asu.edu ATTN: Native American Alumni Chapter Awards Alyssa Bradley arbradl3@asu.edu Old Main Samantha Harris srharr12@asu.edu Box 873702 Tempe, AZ 85287-3702
I. GENERAL INFORMATION Name: ASU ID#: Tribal Affiliation(s): Local Address: (Include City, State & Zip Code) Phone Number: (H): (W): Email: Cell Number: II. EDUCATIONAL INFORMATION Current class standing (circle one): FR SO JR SR Anticipated graduation date: College: Major/Minor: ASU cumulative hours completed to date: ASU cumulative grade point average: III. SCHOLARSHIP AGREEMENT I give my permission for the release of academic, financial, and/or other necessary information requested by the scholarship/award selection committee. Further, if a scholarship/award is awarded to me, my consent is hereby given for the release of academic, financial, or other necessary information requested by the scholarship/award donor. I certify that the information throughout this application is accurate (and in compliance with the criteria stated on scholarship), and that misrepresentation of any facts or details could result in ineligibility for any scholarships/awards. I hereby agree upon the acceptance of the scholarship/award to the terms specified in the scholarship criteria. However, should my status change whereby I no longer meet the criteria, I understand that the scholarship will be revoked. If I receive an scholarship/award, I agree to attend the Josiah N. Moore Scholarship Benefit Dinner to personally accept the award and volunteer time at Native American Alumni Chapter functions. This typically includes: JNM Scholarship Benefit Dinner October 21, 2017 Fall/Spring Native American Convocation December 2017/May 2018 Signature: Date: 1
IV. FINANCIAL INFORMATION Name: ASU ID#: Financial need is an important factor the Native American Alumni Chapter considers in awarding scholarships. List all scholarships, financial awards, grants and/or loans, and their amounts, that you are currently receiving: TOTAL List all scholarships, financial awards, grants and/or loans, and their amounts, that you anticipate receiving the next academic year (2017-2018): TOTAL ATTACH A ONE-PAGE, DOUBLE-SPACED, STATEMENT OF YOUR FINANCIAL NEED FOR THE NEXT ACADEMIC YEAR TO THIS PAGE. CLEARLY show anticipated monies received versus anticipated expenses. This would include scholarships, grants, loans, wages or assistance from parents. If you work during the academic year, provide the number of hours you average each week. Explain any special circumstances you wish the Scholarship Committee to consider. Make sure to include your ASU ID on your Financial Need Statement. 2
V. PERSONAL GOAL STATEMENT Video Submissions If you are submitting a video, you must provide a link to the video on your application form; videos must be viewable without an account or password. Video requirements are as follows: Create a video between one and two minutes long (1:00 2:00). Include your name, city, and state. Consider providing the following information listed inthe bulleted below Upload the video. Videos must be viewable without an account or password. If you are using YouTube, please select public or unlisted from the privacy menu. If you are using Vimeo, please choose anyone from the who can view privacy menu. Name your video. Video title should include your name and the JNM Fall 2017 Example: Bradley Harris JNM Fall 2017 Essay Submissions: If you are submitting an essay, the requirements are as follows:. Attach a personal goal statement at the end of your application packet. Your statement should be typed, double-spaced and no more than two pages in length. The content, punctuation and grammar of this statement greatly impacts your ability to compete for our scholarships. Make sure to include your ASU ID on your Personal Goal Statement. For video and essay submissions, please include the following information: What are your current and future career goals? How have you been involved in your community? What civic, church, or school/college organizations have you, or are you an active member of? How have you been an active member? What leadership roles/positions have you held in these organizations? What honors or awards have you received? Are there any extraordinary situations you wish the Native American Alumni Chapter to consider? How will this scholarship help you meet your academic and career goals? TIPS & CHECKLIST 3
TIPS Print legibly in black ink or type. Check your grammar, spelling and punctuation. It matters. Provide a link to the video on your application form Make sure your address, phone numbers and email addresses are correct. If they change, please contact: Cheryl Begay-Mizell at archaeo@asu.edy Alyssa Bradley at arbradl3@asu.edu Samantha Harris at srharr12@asu.edu Be sure to indicate the easiest way to reach you. Do not forget to sign and date the application. CHECKLIST Make sure the following are complete and included in your application packet: General information Educational information Scholarship agreement Copy of unofficial transcripts Copy of Certificate of Indian Blood/ Enrollment Number Financial information Financial need statement Personal goal statement One letter of recommendation ASU ID# on all forms SCHOLARSHIP DEADLINE: September 29, 2017 Video Essay Terms & Conditions All submitted videos must be original work of the applicant. By submitting a video essay for the Josiah N. Moore Scholarship, the winning applicant automatically grants ASU Native American Alumni Chapter permission to: Use their name and video essay in announcements or articles (i.e. social media, newsletter, etc) issued by ASU Native American Alumni Chapter. Post the applicant s name, video or essay on ASU Native American Alumni web site. Call and/or send information to the applicant regarding their application. Winners will be notified via email, and announced publicly, as well as on ASU Native American Alumni Chapter social media pages. The winner agrees to provide high-resolution.jpeg images or high resolution scans of original prints or negatives for reproduction, and a copy of the video for video essays to the ASU Native American Alumni Chapter. The images, scans, or videos must be received with a signed statement granting the ASU Native American Alumni Chapter the right to use them, according to the stipulations above, prior to the award being released. 4