Ethnic Diversity Scholarship Application
Name
*
First Name
Last Name
Gender
*
Female
Male
E-mail
*
Phone
*
-
Area Code
Phone Number
Primary Ethnicity
*
American Indian
Asian
Black or African-American
Hispanic
White
Other
School
*
Bellarmine
Centre College
Eastern Kentucky University
Northern Kentucky University
University of Kentucky
Western Kentucky University
Other
Year
Freshman
Sophomore
Junior
Senior
5th Year +
Which staff member are you closest to?
*
Please select the event you are requesting a scholarship for:
*
Fall Retreat
New Years Conference
Spring Break
Summer Project
Other
Any other information we should know as we process your application?
I understand that this is a NEED-based scholarship to help students that don't have the resources to pay for this event
*
I understand
Submit
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