Application is due April 1. Please type or print legibly.

NAME OF SCHOLARSHIP APPLYING FOR: __________________________________________

NAME ___________________________________________ PHONE _____________________

PERMANENT ADDRESS:

PRESENT ADDRESS:

PRESENT EDUCATIONAL LEVEL (Circle One): Incoming Freshman, Current Freshman, Sophomore, Junior, Senior

Rhetoric/Communication GPA: ____ Cumulative GPA: ____

Provide a short discussion (either a list or paragraph) of your commitment to the discipline of Speech/Communication. This could include: debate, individual events, Sp/Comm. related internships, services on Sp/Comm. committees, participation in Sp/Comm. related activities. Use the back of the printed form if more space is needed.