ED WILKENS SCHOLARSHIP

ED WILKENS SCHOLARSHIP

UMES ALUMNI ASSOCIATION - BALTIMORE ALUMNI CHAPTER SCHOLARSHIP
SECTION A - APPLICANT INFORMATION
Name*

First NameLast Name
M. I.*
Last 4 of your SSN*
Birthdate*

MonthDayYear
Date
Race (optional)
Gender*
Student's Permanent Mailing Address*
Email*
example@example.com
Address*

Home Address

Street Address Line 2

CityState

Postal / Zip Code
Home Phone No.*
Do you live in Baltimore City?*

YesNo
No If no, which county?*
Is/Are your parent(s) or legal guardian(s) Maryland resident(s)?*

YesNo
Have you been accepted to UMES?*

YesNo
If the answer is yes, upload letter below.
ACCEPTANCE LETTER UPLOAD *

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Intended Major*
Please provide the name and code number of your high school:
School Name*
Address*

School Address

Street Address Line 2

City or County NameState / Province

Postal / Zip Code
Code No.*
Authorization for Release of Educational Records:

In accordance with the Federal Privacy Rights of the Parents and Students Act, the following signed consent is necessary for the UMES Alumni Scholarship Board to receive student information for use in conjunction with the scholarship application. The undersigned, therefore, consents to the release of the applicant's educational records, including recommendations and other information as needed.
Date*

MonthDayYear
Date
Student Signature*

Clear
Parent/Guardian Signature*

Clear
SECTION B COUNSELOR VERIFICATION*
I verify that the above student meets the minimum requirement of a 2.50 grade point average, based on a 4.0 scale for academic studies. The student's overall GPA for grades 9, 10, and 11 is ACT In addition, I am attaching a copy of the applicant's official transcript.
Signature of Counselor*

Clear
Office Phone*
Date*

MonthDayYear
Date
500 word essay questions

"What is one thing you would change about the HBCU culture?"
500 word essay document upload

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RECOMMENDATION LETTER #1*

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RECOMMENDATION LETTER #2*

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TRANSCRIPT UPLOAD *

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Should be Empty: