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Merit Scholarship Estimate Form

After you submit this form, it will be reviewed by admissions staff who will then contact you to discuss your scholarship estimate. The information returned by the reviewer is in no way a guarantee or final value for a scholarship.

First Name: Middle Initial:
Last Name:
Gender: Male
Female
Ethnic Background (optional):
African-American
Asian/Pacific Islander
Caucasian
Hispanic
Native American
Multiracial
Other
Street Address:
City: State: Zip:
Country:
Phone Number:
E-mail Address:
Confirm E-mail Address:
Academic/Career Interests:
Current High School/College:
City of High School/College:
State of High School/College:
Year of Graduation:
List all colleges at which you have taken courses for credit. Please have an official transcript sent from each institution as soon as possible. (List the name of college, its location (City, State, Zip Code), whether you were a degree candidate, and the dates attended.
High School Grade Point Average:
High School Rank in Class:
(your rank / total class number)
SAT:
(Please list the dates taken/ to be taken and designate Critical Reading score, Math score, and Writing score.)
ACT:
(Please list the dates taken/ to be taken, each category score and composite score.)
Senior Year Curriculum:
(Please list your senior year classes in the areas of English, Math, Science, Social Science and Foreign Language.)
Briefly describe any scholastic distinctions or honors you have achieved during high school beginning with ninth grade:
Please list your principal cocurricular, community, and family activities and hobbies in the order of their interest to you. Include specific events and/or major accomplishments such as musical instrument played, varsity letters earned, etc.
Please indicate (*) those activities you hope to pursue in college:
Are you planning to participate in a music ensemble while in college? Yes
No
Are you planning to participate in debate? Yes
No
Are you planning to participate in theatre, technical theatre, dance or playwriting? Yes
No
Are you planning to major in Art? Yes
No
Do you have a relative who attended Augustana College? If yes please list their names below Yes
No

By checking this box and typing my full legal name in the box below,
I agree that all information in this application is complete, factually correct and honestly presented.

Name verification:
Date: