2016 Scholarship Application Form - Current College Students - Ukrainian Technological Society of Pittsburgh

2016 Ukrainian Technological Society Scholarship Application for Current College Students

Eligibility – The Society offers scholarships to college/university or graduate students of Ukrainian ancestry domiciled in Western Pennsylvania from Altoona, PA westward to the PA-OH and PA-WV state lines, areas surrounding Austintown-Youngstown, OH, the West Virginia panhandle between PA and OH including Wheeling, WV, and areas surrounding Morgantown, WV.
Application – A new, completed application is necessary for each year. The application consists of both the completed UTS Scholarship Application Form and your official academic transcript issued by your school's registrar showing all courses taken and grades received. Please contact your registrar as soon as possible to secure your official transcript. Unofficial transcripts downloaded from websites, etc. are NOT acceptable. Entering first year college/university students should submit their completed high school transcript. Second, third, and fourth year returning and graduate students should submit their college/university transcripts. Please complete all sections of the Application Form; incomplete Application Forms will NOT be considered. Official school transcripts are to be sent to: UTS Scholarship Committee, P.O. Box 4277, Pittsburgh, PA 15203.
Selection Criteria – Scholarships are based primarily on academics and potential for benefiting the Ukrainian Community after graduation. Please see the Scholarship Program page for additional requirements of sponsored scholarships.
Due Date – Complete your online application no later than July 8, 2016. Your official transcripts must also be received by the Scholarship Committee by this date.
Awards Ceremony – Scholarship awards will be made on Sunday, August 7, 2016 during the Awards Ceremony and Social. We ask that all award recipients attend to acknowledge the support of our community donors.

Questions can be sent to [email protected].

Personal Information

* Indicates required field

Name *

First

Last

Address *

City *

State *

Zip Code *

Email *

Phone Number *

Father's Name *

First

Last

Mother's Name (include maiden name) *

First

Last

Describe your Ukrainian heritage or your family's connection to Ukraine. *

Please explain any circumstances that affect your financial need *

University Information

University Name *

University Location *

Major *

Expected Year of Graduation *

Grade Point Average *

Maximum GPA *

List your University academic achievements, honors or awards.

Award Name

Award 1 *

Award 2 *

Award 3 *

Award 4 *

Award 5 *

Award 6 *

Award 7 *

Award 8 *

Award 9 *

Award 10 *

Date Received

Award 1 *

Award 2 *

Award 3 *

Award 4 *

Award 5 *

Award 6 *

Award 7 *

Award 8 *

Award 9 *

Award 10 *

List any additional academic achievements, honors or awards that could not fit above.

Please write your answer here. *

List your University non-academic achievements, honors, awards or leadership positions held.

Achievement Name

Achievement 1 *

Achievement 2 *

Achievement 3 *

Achievement 4 *

Achievement 5 *

Achievement 6 *

Achievement 7 *

Achievement 8 *

Achievement 9 *

Achievement 10 *

Relevant Date(s)

Achievement 1 *

Achievement 2 *

Achievement 3 *

Achievement 4 *

Achievement 5 *

Achievement 6 *

Achievement 7 *

Achievement 8 *

Achievement 9 *

Achievement 10 *

List any additional non-academic achievements, honors, awards or leadership positions held that could not be listed above.

Please write your answer here. *

Ukrainian Community Involvement

List your membership in Ukrainian secular or religious organization(s).

Organization

Activity 1 *

Activity 2 *

Activity 3 *

Activity 4 *

Activity 5 *

Activity 6 *

Activity 7 *

Activity 8 *

Activity 9 *

Activity 10 *

Dates of Membership

Activity 1 *

Activity 2 *

Activity 3 *

Activity 4 *

Activity 5 *

Activity 6 *

Activity 7 *

Activity 8 *

Activity 9 *

Activity 10 *

Leadership Position(s)

Activity 1 *

Activity 2 *

Activity 3 *

Activity 4 *

Activity 5 *

Activity 6 *

Activity 7 *

Activity 8 *

Activity 9 *

Activity 10 *

Dates of Leadership

Activity 1 *

Activity 2 *

Activity 3 *

Activity 4 *

Activity 5 *

Activity 6 *

Activity 7 *

Activity 8 *

Activity 9 *

Activity 10 *

Contribution

Activity 1 *

Activity 2 *

Activity 3 *

Activity 4 *

Activity 5 *

Activity 6 *

Activity 7 *

Activity 8 *

Activity 9 *

Activity 10 *

List any additional Ukrainian involvement that could not be listed above.

Please write your answer here. *

List any Ukrainian language or cultural classes you have taken.

Class Name

Class 1 *

Class 2 *

Class 3 *

Class 4 *

Class 5 *

Class 6 *

Class 7 *

Class 8 *

Class 9 *

Class 10 *

Location

Class 1 *

Class 2 *

Class 3 *

Class 4 *

Class 5 *

Class 6 *

Class 7 *

Class 8 *

Class 9 *

Class 10 *

Date

Class 1 *

Class 2 *

Class 3 *

Class 4 *

Class 5 *

Class 6 *

Class 7 *

Class 8 *

Class 9 *

Class 10 *

List any additional Ukrainian classes that could not be listed above.

Please write your answer here. *

Essay

Please answer the following essay questions (400 words maximum): How can you contribute to the betterment of the Ukrainian community through your educational pursuits?

Please write your answer here. *

Certification and Awards Attendance Requirement

I certify that the responses herein are my own and are true and correct. I understand that
if I am chosen for a scholarship, that I must attend the Scholarship Awards Ceremony and
Social. If I am unable to attend in person, I will be represented by a family member. The
Awards Ceremony is scheduled for a Sunday, August 7, 2016.

Please choose only one of the following: *

Yes No

Submit

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COPYRIGHT © 2016 UKRAINIAN TECHNOLOGICAL SOCIETY OF PITTSBURGH. ALL RIGHTS RESERVED.
THE UTS IS AN IRS 501(C)(3).

The official registration and financial information of the Ukrainian Technological Society may be obtained from the Pennsylvania Department of State by calling toll-free, within Pennsylvania, 1-800-732-0999. Registration does not imply endorsement.