Student Services
Scholarships

Note: * denotes a required field


Student USFID: *   (U########)
  
     
Today's Date: *   as (month/day/year)
  
First Name: *
 
Middle Name:
 
Last Name: *
 
Nickname:
 
     
Local Address:
 
City:
 
State:
 
Zip Code:
 


Please try contacting me first by

     
Contact Phone #:   as (###-###-####)
  
(2nd) Phone #:
 
     
Contact E-mail:
 
(2nd) E-mail:
 

In case of an emergency please call:

     
Name:
 
Relationship to you:
 
     
Contact Phone #:   as (###-###-####)
  
(2nd) Phone #:
 


Please respond to all of the general questions below.

1)  Which engineering discipline do you plan to major in?
      (check all that apply)*

Chemical Engineering Electrical Engineering  
Civil Engineering Industrial Engineering  
Computer Engineering Mechanical Engineering  
Computer Science Undecided Engineering  


    If you checked more than one discipline, which is your first choice?
     

2)  Are you receiving financial aid?

Yes No  

3)  Are you a Bright Futures (Florida Medallion/Merritt) Scholar recipient?

Yes No  

4)  Are you receiving VA (veteran) benefits?

Yes No  


    If yes, has your Certification of Credit for Prior Training been completed?

Yes No  

5)  Are you receiving an athletic scholarship?

Yes No  

6)  Are you an international student?

Yes No