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When you have completed this form, please print out and fax it to 505-277-1250, or mail it to: PPD Scholarship Committee, Physical Plant Department, 1818 Camino del Servicio, Albuquerque, NM 87131-3500.

Application Instruction:

The applicant should read the material in the current University Bulletin about the scholarship for which he/she is applying, and should make certain that the information required by the Prizes and Awards Committee is correct and complete and supplied in full. This includes data on need, scholarship (including academic status and grade point average), residence, and other considerations. When required, be sure to attach recommendations from faculty members and others. Application must be received on or before the deadline set by the Physical Plant Scholarship Committee.

PERSONAL DATA:

Last Name: First Name: Middle:

Address:

City, State, Zip:

SSN:

Are you a resident of New Mexico : Yes No

If yes, for how long?

Name of employee(s) of the Physical Plant through whom you have established eligibility for the scholarship program:
Date(s) of PPD employment:

ACADEMIC PERFORMANCE:

Academic Status (number of hours earned to date):

Proposed degree and date of graduation:

TRANSCRIPT INFORMATION:

Attach a copy of your most recent transcript, including results of last semester.

FINANCIAL NEED:

To what extent are your parents or guardians financing your education?

To what extent do you earn your expenses for college, including summer employment?