"Be the Change" Scholarship Application
Do you have an idea to help heal the divide in our country? Fight racism, xenophobia, or Islamophobia? Support refugees? Feed the hungry? House the homeless? Promote rights for women or the LGBT community? Protect our air and water? Create sustainable jobs in struggling cities or rural areas? Inspire trust in science?

Turn your idea into action!

All current University of Utah students that plan to take 6 credits or more during the fall of 2017 are eligible.

First and Last Name
Your answer
University ID Number
Your answer
Email
Your answer
Major
Your answer
GPA
Your answer
What are your future plans? (2-10 sentences)
Your answer
When do you plan to graduate?
Describe the problem you hope to address. What are the specific goals of your project?
Your answer
What specific action do you have planned to address the problem described above?
Your answer
What challenges do you expect to face? How do you plan to address these challenges?
Your answer
Describe the group of people you hope to impact. How many people will be impacted? How do you plan to measure your impact?
Your answer
What resources will you need to carry out your plan and achieve your goals?
Your answer
Provide any other information you feel is relevant.
Your answer
Please provide the name and contact information for two people that can speak to your motivation, work ethic, leadership abilities, and ability to carry through on tasks. Family members may not serve as references.
Reference 1 Name
Your answer
Reference 1 Phone Number
Your answer
Reference 1 Email Address
Your answer
Reference 2 Name
Your answer
Reference 2 Phone Number
Your answer
Reference 2 Email Address
Your answer
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