Blank NAPCOE Scholarship Application for Printing

GENERAL SCHOLARSHIP APPLICATION

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Navajo Engineering Construction Authority (NECA) Engineering, Construction Mgt./Tech., Financial/Business Mgt., Accounting, Pre-Med., Nursing, Teaching

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Norfolk State University (Chemical & Mechanical Engineering)

Name of Applicant:_________________________________________________ Soc. Sec #:_______________________

Current Address:__________________________________City:_____________________ State:_______ Zip:_________

Telephone/ Area Code:_____________________ County:___________________________ Email:___________________

Permanent Address:_______________________________ City:_____________________State:________ Zip:_________

Current Address:__________________________________City:_____________________ State:_______ Zip:_________

Telephone/ Area Code: ________________________ County:_______________________

ETHNIC BACKGROUND:

Tribal Affiliation:__________________________ Census#:____________________

EDUCATIONAL BACKGROUND:

High School Attended: _______________________________________________________________________________

Year Graduated:____________ Couselor:____________________ Class Rank:________ HS GPA:_______ ACT:_______

Years Attending UNM:______ Major:_________________ Cum. GPA:________ Anticipated Graduation Date:__________

Are you a trandser student? (Y/N) ____________ If so, from Where? _______________________________

EDUCATION OF PARENTS
	Mother	Father
Grade School or Less:	[ ]	[ ]
Some High School, but not a graduate	[ ]	[ ]
High School Graduate:	[ ]	[ ]
Some College but not a graduat	[ ]	[ ]
Two-year college Degree	[ ]	[ ]
Four year college Degree	[ ]	[ ]
Master's Degree	[ ]	[ ]
Doctorate Degree	[ ]	[ ]

Scholarships Currently Receiving:

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_____________________________________________________________________________________________
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Honors/Awards:

All the information on this application is true and complete to the best of my knowledge. I do hereby
consent to the release of information concerning my academic and financial status to scholarship donors.

____________________________________________________________________________________________
Signature / Date

PLEASE SUBMIT THE FOLLOWING WITH YOUR APPLICATION:

High School:

1. Official Transcript
2. ACT Scores
3. Cerificate of Indian Blood (CIB)

SUBMIT YOUR APPLICATION TO:

UNM NAPCOE
Attn: Ursula T. Bowie
Engineering Annex Rm. 112
Albuquerque, NM 87131