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2013-14 Augustana Science Scholarship Application

For transfer students

If you are currently a high school student, apply here.

  • For transfer students, the priority application deadline is June 1, though students are strongly encouraged to apply well before then.
  • If you are a student currently attending another college/university and plan to enter Augustana mid-year, please contact Dr. Lori Scott at 309-794-3440 or loriscott@augustana.edu for more information.

Your Augustana College Admissions application, supporting documents, and financial aid paperwork, including the FAFSA, must also be completed by these deadlines.

1.
Name (first and last name) *

2.
Home street address, including (if applicable): PO box, apartment number

City, state and zip code

3.
Email address
We will contact you via this email regarding scholarship decisions.

4.
Home phone number, beginning with area code (123-456-7890)

5.
Cell phone number, beginning with area code (123-456-7890)

6.
What is your gender?
Female
Male

7.
Are you Hispanic/Latino (including Spain)?
If you respond "yes", please describe your background in the box provided.
Yes
No
If yes, describe your background

8.
Regardless of your answer to the prior question, please indicate how you identify yourself.
  Yes No
American Indian or Alaska Native (including all Original Peoples of the Americas)
Native Hawaiian or other Pacific Islander (Original Peoples)
Asian (including Indian subcontinent and Philippines)
Black or African American (including Africa and Caribbean)
White (including Middle Eastern)
If you prefer not to identify your ethnic background, then choose "Yes" for this response.

9.
Do you have a disability?
Yes
No

10.
Have you completed the 2013-14 FAFSA (www.fafsa.ed.gov)
Yes, I have completed a FAFSA.
No, I have not completed the FAFSA form. However, I anticipate that it will be completed by the deadline listed above (June 1).

11.
Intended major(s)? Choose all that apply.
Biology
Biochemistry
Chemistry
Engineering
Geology
Mathematics
Physics
Pre-Medicine
Secondary Education - Biology
Secondary Education -Chemistry
Secondary Education - Mathematics
Secondary Education - Physics
Unknown at this time
Other:

12.
Which of the following courses have you sucessfully completed or plan to take prior to entering Augustana? Choose all that apply.
  Yes, this course is completed. Will take this course during the current academic year Will not have this course prior to entering Augustana
One or more semesters/terms of high school biology
One or more semesters/terms of college biology
One or more semesters/terms of high school chemistry
One or more semesters/terms of college chemistry
One or more semesters/terms of high school physics
One or more semesters/terms of college physics
Pre-calculus in high school or college
Calculus in high school or college

13.
If you completed precalculus or calculus, what grade did to earn?
A
B
C
D
F

14.
Are you now or have you attended another college or university?
Yes
No

15.
Essay: Describe your career goals and any experiences that helped you decide upon this career path.

By submitting this application you are giving the Augustana College Science Scholars Scholarship Committee permission to acquire additional information as needed from other campus offices. These offices include, but are not limited to: Admissions Office, Registrar's Office, Financial Assistance Office.