The Assyrian Universal Alliance Foundation Scholarship

The Assyrian Universal Alliance Foundation Scholarship Program
2015/2016 APPLICATION
Please review the attached letter describing the AUAF Scholarship Program carefully before completing this
application (Program Letter). Only those students meeting the eligibility requirements described in the Program Letter
should apply.
Applications must be legible, complete, and accurate. Failure to meet these requirements may adversely impact the
evaluation of your application and chances of receiving a scholarship. Applicants are responsible for gathering and
submitting all necessary information. Applications are evaluated on the information supplied; therefore, answer all
questions as completely as possible. Incomplete or illegible applications will not be evaluated. All information
received is considered confidential.
Deadline: June 26, 2015. Applications will not be evaluated if received after this date.
Please Type:
1. Last Name: ______________________
2. Male: □
First Name:________________________________
Female: □
3. Mailing Address: _______________________________________________________________
4. E mail address: _________________________________________________________________
5. Telephone Number: (_______)__________________
6. Birth Date____________________________________
7. Father’s Full Name: ______________________________
Mother’s Full Name: ______________________________
8. If you are currently a Senior in high school or have just completed your senior high school, please provide
the following information:
Name, mailing address, and telephone number of High School currently attending:
_____________________________________
_____________________________________
______________________________________
______________________________________
9. If you are a high school graduate, provide the following information:
a.
Name, mailing address and phone number of the accredited two or four year college,
University or vocational / technical school where you are currently enrolled:
_____________________________________
_____________________________________
______________________________________
______________________________________
b.
Current level of study: Freshman ____ Sophomore ____ Junior____ Senior____
10. Name of the two or four year college, university or vocational/technical school you will attend in the Fall of
2015:_____________________________ Major:_______________________ Tuition: $_______________
11. Assyrian/American background: At least one parent must be of Assyrian descent. Please indicate which of
your parents, if any, is of Assyrian descent:
Father_______ Mother ________
NOTE: If you are granted a scholarship, it will be paid directly to the school you have indicated you will
attend for the 2015/2016 Academic Year. Be sure the school you list above is the school you will attend for the
2015/2016 Academic Year.
The following information must be submitted to the Scholarship Committee along with your completed and
signed application:
1. Personal Statement/Essay:
Please prepare a 1-2 page typed single-spaced personal statement describing your Assyrian background, personal
achievements, academic achievements, leadership skills and community involvement. Please include a
description of your current school and other activities, career goals and your current and potential contributions to
the Assyrian community. Feel free to include any additional information you feel is relevant to this application.
Your personal statement is one of the most important aspects of this application and is equivalent to an interview.
Accordingly, it should be addressed solely to the AUAF Scholarship Committee and must be attached to your
application.
2. Transcript:
High school graduates must include an official school transcript bearing the school seal, and showing your class
rank and grade point average. It can be obtained from your School Counseling Office.
Currently enrolled College/University/Vocational Students must include an official transcript bearing the
school seal, including all coursework and showing your cumulative grade point average. If you have attended
more than one school an official transcript from each and every attended must be submitted.
3. Recommendation Letters:
Two letters of recommendation from school officials are required. Recommenders must comment on your recent
performance and potential to succeed in college-level coursework, as well as other factors indicating your
potential for future success. Recommendation letters must (i) accompany your application (i.e., they must be
included in your application package; (ii) be on school letterhead; and (iii) be in a sealed envelope.
Previous scholarship recipients are not required to submit new recommendation letters.
4. Proof of acceptance into (or enrollment in) an accredited two or four year college, university or
vocational/technical school
5. Copy of Illinois driver’s license or State issued identification card verifying residency in the State of Illinois
Applications must include all of the information and documents set forth above. Application packages
missing any required information or documents will be deemed incomplete and will not be considered.
Completed Application Packages must be sent to:
Assyrian Universal Alliance Foundation
Attention: Scholarship Committee (Susan Birwari)
4343 W Touhy Ave.
Lincolnwood, IL 60712
I, _____________________________________(insert your name), represent and warrant to AUAF that (i) all of
the information set forth above in this application is true and correct; (ii) all of the documents that I submitted
to AUAF in connection with my scholarship application are true and correct and have not been altered,
modified or falsified in any manner; and (iii) I will be enrolled as a full-time student in a college, university,
vocational or technical school for the 2015-2016 academic year. I understand and agree that any breach of my
representations or warranties set forth above will result in the immediate revocation of my scholarship (if
granted) and that I will be liable for repayment of the full amount of such scholarship.
ACKNOWLEDGED & AGREED:
Signature:__________________________________________ Date:____________________________
Please Type Your Name: _______________________________________________
If under the age of 18, your parent or legal guardian must also sign below:
Signature of Parent or Legal Guardian:______________________________________________
Please Type Name of Parent or Legal Guardian: _______________________________________