- - - Social Security Number


- Last Name
- First Name
- Middle Name

- Permanent Mailing Address
- City
- State
- - Zip Code


- - - Home Phone Number

- E-Mail Address

- Anticipated/Current Academic Major

Continuing TWU Student Entering Freshman Student Entering Transfer Student Entering Graduate Student Entering International Student - 2008-2009 TWU Enrollment Status

Texas Resident Paying In-State Rate Non-Texas Resident Paying Non-Resident Rate Non-Texas Resident Paying In-State Rate - Tuition Rate

Fall Spring Summer - First Semester at TWU

Please check scholarships(s) for which you are applying:

General Academic Scholarship (all full-time TWU students)

New Freshman Student Scholarship

New Graduate Student Scholarship

Phi Theta Kappa Scholarship (Transfer Students)

TWU Presidential Scholarship (Valedictorian/Salutatorian)

New Transfer Student Scholarship

New International Student Scholarship

McNair Scholars Scholarship (Graduate Students)
    (Must have been an undergraduate McNair Scholar and must attach a letter of
     verification from your McNair advisor)

Mary Bryan & Tom C. Reitch Scholarship (TO APPLY FOR THIS SCHOLARSHIP, YOU MUST COMPLETE THE SUPPLEMENTAL QUESTIONS AT THE END OF THIS APPLICATION)
 

 HIGH SCHOOL INFORMATION:

(To be completed by scholarship applicants who have not attended college or who have completed less than 13 hours at the college level.)

Name of High School

City 
State 
Zip Code

High School Graduation Date

High School Cumulative GPA

High School Class Rank

SAT/ACT Score

COLLEGE TRANSFER INFORMATION:

(To be completed by scholarship applicants who are entering transfer or entering graduate students.)

Last College/University Attended

City  State  Zip Code

Date of Attendance

Graduated:  Yes     No

Degree Granted     Date of Degree

Cumulative GPA   

SUPPLEMENTAL REITCH SCHOLARSHIP QUESTIONS: (To be completed by Reitch Scholarship applicants only)

Single Married Separated Divorced Widowed - Marital Status

Do you have family members, other than yourself, who are attending college at least halftime?

- Yes  - No

If yes, how many and what relation? 

Do you have dependent children?

- Yes  - No

If yes, how many and what ages? 

Do you plan to work while attending TWU?

- Yes  - No

If yes, how many hours per week and what are your gross earnings?

Is there any special circumstances that prevents you from working while attending TWU?  Explain.

Have you or your family experienced a hardship that negatively impacts your or your family's ability to meet your educational expenses?  Consider such things as illness, unusually high medical expenses, special educational needs, bankruptcy, etc.

Total amount borrowed to date on all student loans, if any: 

Please provide any other information that would describe your need for the Mary Bryan & Tom C. Reitch Scholarship

I understand that I must enroll fulltime in order to qualify for scholarships.  I also understand that entering students must be admitted to Texas Woman's University in order to be considered for scholarship awards.  I give TWU permission to release any information about my scholarships, activities, awards or honors to the news media and the donor of my scholarship funds.  I certify this information to be true and correct to the best of my knowledge.

SIGNATURE:
By checking this box you have created an electronic signature as legally binding as your hand-written signature.

Date: - -

WARNING: ANY PERSON WHO KNOWINGLY MAKES A FALSE STATEMENT OR MISREPRESENTATION ON THIS FORM (OR RELATED DOCUMENTS) SHALL BE SUBJECT TO A FINE OF NOT MORE THAN $10,000 OR TO IMPRISONMENT OF NOT MORE THAN FIVE YEARS, OR BOTH, UNDER PROVISIONS OF THE UNITED STATES CRIMINAL CODE.

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