GEAR UP Wyoming Federal Scholarship Application and UW Institutional GEAR UP Scholarship Application
ATTENTION: DO NOT SUBMIT this application if you have not yet filed your FAFSA, as your FAFSA Confirmation Number and Expected Family Contribution Number are needed!

This application may not be completed in parts - it may only be submitted once in its entirety. Any missing information will render the entire application incomplete.

Application Deadline: April 1 (for Fall semester) and November 1 (for Spring semester).

By submitting this application, you are consenting that your attending institution may provide financial aid and academic information to the Wyoming GEAR UP Office in order to confirm your continued eligibility and calculate your GEAR UP scholarship award.

First Name: *
Your answer
Last Name: *
Your answer
Home Phone: *
XXX-XXX-XXXX
Your answer
Cell Phone: *
XXX-XXX-XXXX
Your answer
Birth Date: *
MM/DD/YYYY
Your answer
E-mail Address: *
Your answer
Verify E-mail Address: *
Your answer
Permanent Address: *
Your answer
City: *
Your answer
State: *
Zip: *
Your answer
Social Security Number (SSN) *
Your answer
Will You Receive a Diploma or GED? *
Planned High School Graduation Date: (if none type NA) *
MM/DD/YYYY
Your answer
Cumulative GPA/GED Score: *
Your answer
Composite ACT Score: *
Your answer
High School Graduated: (if none type NA) *
Name of high school from which you will graduate:
Your answer
Date Enrolled in GEAR UP: *
MM/YYYY
Your answer
Date Your FAFSA was Filed: *
MM/DD/YYYY (Note: More of your FAFSA information will be needed below in this application.)
Your answer
Name & City, State of College You Plan to Attend: *
Name - City, State
Semester You Plan to Begin School: *
Have you attended a community college (full or part-time)? *
If so, which community college (full or part-time) did you attend? *
If none please choose None
If so, how many semesters (full or part-time) did you attend the community college? *
If none please choose None
Are you a U.S. citizen? *
Have you received a Daniels Fund Scholarship? *
What major do you plan to pursue in college? *
Your answer
Please provide your FAFSA Confirmation Number (F XXXXXXXXX XX):
This may be found in your FAFSA e-mail confirmation
Your answer
Please provide your FAFSA Estimated Expected Family Contribution (EFC): *
This may be found in your FAFSA e-mail confirmation or by signing in to your FAFSA account.
Your answer
Please list all scholarships for which you have applied here: *
Please do not include GEAR UP or Hathaway, 1,2,3...
Your answer
Please list all of your work experience and/or volunteer/extracurricular activities in which you have participated here: *
1,2,3...
Your answer
Name of your GEAR UP Outreach Coordinator: *
Location of Your Host GEAR UP Program *
Student Applicant Signature: *
By checking the box below, I verify that all the information I have given in this application is true and correct to the best of my knowledge and understand that any false information will result in my disqualification of this scholarship without the ability to appeal.
Required
Date you are submitting this completed application: *
MM/DD/YYYY
Your answer
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