PROGRAM SCHOLARSHIP APPLICATION  
DEPARTMENT OF AUTOMOTIVE TECHNOLOGY

Please complete all sections of this application. Type or print neatly using black ink. Use N/A if the question does not apply. Appearance and completeness will be considered as your application is evaluated. Please complete this application and return as soon as possible.

I. Personal Information:                                            Date of application:________

Name:_________________________________                     Social Security Number: ______-______-_______   
            Last                             First                     Middle                                  BYU-I I.D. Number:            ____________________________                              
Permanent Home Address:__________________________________________________________________________
                                                               Street Address                                  City
 _________________________________        __________________________           __________________________________________
                 State or Non-US Province                                Zip Code                                                                       Country

Home Phone Number: (       )_____ -_________ Local Phone Number: (       )_____ -_________    Birth Date:          /           /             Age: ______

II. Scholastic Information, Work, and Other Experience:


High School: ____________________________         City:_________________________________

State: __________________   Zip Code ____________ Date of Graduation:         /          /                   GPA: _________

Previous Post High School Education:

__________________________ ________________________   from ________ to ________   __________________
          College or Institution                                  Location                                   mo/yr                mo/yr               Degree Earned

__________________________ ___________________________  from ________ to ________ ___________________
          College or Institution                                          Location                                   mo/yr                mo/yr              Degree Earned

Cumulative College GPA: ______    Previous Automotive or Related Classes:_____________________________________

Automotive Related Work Experience:__________________________________________________________________

Other Work Experience: _____________________________________________________________________________

Hobbies in Automotive: _____________________________________________________________________________

Projects, Awards and Special Scholastic Achievements or Recognition:__________________________________________

Extra-Curricular Activities: ____________________________________________________________________________

Any Other Factors You Feel Should Be Considered:_________________________________________________________

 


III. Why do you feel that you are qualified for a Departmental Scholarship? _____________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

IV. Eligibility:

Receiving and retaining a Departmental Scholarship is contingent upon your:
  • Being accepted into BYU-Idaho
  • Being a full time student (12 or more semester hours).
  • Being chosen by the Selection Committee to receive a Departmental Scholarship
  • Maintaining at least a 2.8 GPA throughout the duration of the scholarship.
  • Declaring AUTOMOTIVE TECHNOLOGY (346) as your major and being actively enrolled in the correct classes for that major throughout the duration of the scholarship.

V. Year and Semester or Term you applying for this scholarship: Year: ______

_______ Fall Semester      _____Winter Semester      ______ Summer Term   

VI. Signature: ___________________________________ Date: _______________
Note:
This application must be completed, signed, and returned with a high school or college transcript to:
     Dondavid S. Powell
     Brigham Young University-Idaho
     Austin 126
     Rexburg, Idaho 83460-1000
(Letters of recommendation are optional.)


(For Selection Committee Use Only)

Date Application Received:_____/_____ /_____ Items Needed to Complete Application: ___________

Date of Committee Review:_____ /_____ /_____ _____    Approved _____     Denied  __________

Semester or Term and Amount:

        Fall: ______               Winter: ______           1st Summer: ______             2nd Summer: ______
Notified:______________________