Application for Upperclassman Physics Scholarships

Name ________________________________ , ________________________________ _____
     LAST                               FIRST                            MI

SSN _________________________________   Date _________________________________

Local Mailing Address ________________________________________________________

Local Phone ____________________________

High School _________________________________ Town____________________________

ACT Scores: MATH _____ SCIR _____ READ ______  ENGL ______  COMP ______

University Semester Hours Completed ___________________________________

  Grade Point Average (A = 4 pts.) ________________________  (must exceed 3.0)

Physics Courses and Grades ___________________________________________________

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Math Courses and Grades ______________________________________________________

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 Physics and Math Grade Point Average _____________________  (must exceed 3.0)

Expected Graduation Date ______________________________________________________

What other scholarships do you currently have 
(eg. the Chancellor's or Governor's scholarships)?
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Do you wish to be considered for the Rear Admiral William C. Bryson
Scholarship?___________________________________________________________________

If applying for the W. C. Bryson Scholarship, in what ways have you demonstrated 
an interest in astronomy?

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