PENN STATE SCHUYLKILL

WYLONIS SCHOLARSHIP AWARD

APPLICATION FOR SCHOLARSHIP CONSIDERATION

DEADLINE IS MARCH 8, 2014

 

Student Name (First, Middle, Last)
Student Address
Student City
Student State and Zip Code
Student Email:
Phone (Home)
Phone (Cell)
High school attended
Reference #1 name and title: High school academic achievements reference (administrator, teacher, or guidance counselor)
How do you know Reference #1?
Reference #1 phone number
Reference #2 name and title: Community leader who has personal knowledge of your community activities and participation
How do you know Reference #2?
Reference #2 phone number
Reference #3 name and title: Teacher, adviser/coach, or employer who can attest to your leadership and entrepreneurial potential
How do you know Reference #3?
Reference #3 phone number
List your most notable activities, work, and community service experience. (Please type no less than 5 achievements in a Word document and then copy and paste it into the box.)

By clicking on the "Submit Form" button below, I certify that I am a resident of Schuylkill County, and do hereby apply for the Wylonis Scholarship Award for the 2014-2015 academic year. I fully understand that any scholarship granted to me is not a vested right binding upon the donor or the Pennsylvania State University, and that the scholarship may be revoked should I fail to continue as a student at the Pennsylvania State University or fail to continue to meet the standards established for this scholarship program.

By clicking on the "Submit Form" button below, I confirm the accuracy of the information contained herein as well as my understanding of the conditions of this scholarship program and my acceptance of them.

This publication is available in alternative media on request. The Pennsylvania State University is committed to the policy that all persons shall have equal access to programs, facilities, admission and employment without regard to personal characteristics not related to ability, performance, or qualifications as determined by University policy or by state or federal authorities. It is the policy of the University to maintain an academic and work environment free of discrimination, including harassment. The Pennsylvania State University prohibits discrimination and harassment against any person because of age, ancestry, color, disability or handicap, genetic information, national origin, race, religious creed, sex, sexual orientation, gender identity, or veteran status and retaliation due to the reporting of discrimination or harassment. Discrimination, harassment, or retaliation against faculty, staff, or students will not be tolerated at The Pennsylvania State University. Direct all inquiries regarding this Nondiscrimination Policy to the Affirmative Action Director, The Pennsylvania State University, 328 Boucke Building, University Park, PA 16802-2801: tel. 814-863-0471/TTY. U.Ed. SLO 14-106