Scholarship Form

Incoming Scholarship
Please fill in all fields required, except those otherwise noted.
E-mail
Cell Phone Number
Street Address
City
State
GPA
ACT/SAT Score
1. Briefly list all academic awards/achievements you received while in high school:
2. Briefly list all extracurricular activities/sports you participated in while in high school:
3. Please briefly explain why you chose to attend Southeast Missouri State University:
4. Explain why you feel you are deserving of this scholarship. Be as open and honest as you feel is necessary:
5.(Optional) If you feel it is necessary to provide additional information, please do so below: