Foundation Scholarship Form

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First Name *

Last Name *

Campus Wide ID

Birthdate

Email *

Permanent Address

Address Line 1 *

Address Line 2

Apartment #, Suite #, etc.

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City *

State *

Zip Code *

Parish/County *

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Home Phone

Cell Phone

Local Address

If applicable

Address Line 1

Address Line 2

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City

State

Zip Code

Local Telephone Number

Enrollment Status

High School Graduation Date

Do you consider yourself to be Hispanic/Latino, Not Hispanic/Not Latino, or Prefer not to respond?

Race (Please select one or more that apply)

Gender

ACT Score

SAT Score

High School GPA

College GPA (if applicable)

Academic College

Intended Major

High School

Will you be living on campus?

Are you a first generation college Student? (Neither parent is a graduate of a 4-year University)

Is either parent/guardian a graduate of NSU?

Parent Names

Parent Address

Address Line 1

Address Line 2

City

State

Zip Code

Honors and Extra-curricular activities *

List any Honors you have received, including academic, extacurricular, athletic, community service, etc.

Short Essay - Please explain why you financially need assistance *

I certify that the information submitted is true and complete to the best of my knowledge *

I certify the above statement to be true