Request edit access
SHAPE Michigan Scholarship Application
Email address *
NAME
Your answer
ADDRESS
Your answer
PHONE NUMBER
Your answer
EMAIL
Your answer
SHAPE MICHIGAN MEMBER
Major(s)
Your answer
Minor(s)
Your answer
Current Class Standing
Overall GPA
Your answer
I am enrolled in at least 12 credits as an undergraduate or 6 credits as a graduate student
I will be enrolled in at least 12 credits undergraduate or 6 credits grad work in Fall 2017
A essay of no more than five (5) typed pages (double-spaced & 12 point font) that discusses your future goals, extracurricular activity, community service, professional development, and leadership opportunities.
Your answer
I Plan on Attending the Awards Dinner (October 27th , Lansing, MI)
I agree to submit to mahperded@gmail.com a typed final report of 1-3 pages to the Scholarship Committee, no later than the annual convention of the following year after acceptance of the Scholarship funds, describing the extent to which the scholarship aided in my professional preparation.
Two (2) letters of support from your college/university advisor and/or other professors or supervisors familiar with your academic work, extracurricular activity, community service, professional development, and leadership work. These letters are to be sealed in an envelope Roger S. Jackson Executive Director/C.O.O.SHAPE Michigan PO Box 27187 Lansing, Mi 48909
APPLICANT SIGNATURE By entering your initials in the box below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of St. Johns Public Schools. Report Abuse - Terms of Service - Additional Terms