Brand Boeshaar Scholarship Application

General Information

Name:
Social Security Number:
Birthdate:
Sex:	MF
Name(s) of Parent(s) or Guardian(s):
Street Address:
City, State, Zip Code:
Phone:	() -
Email:

Education Information

High School:
Street Address:
City, State, Zip Code:
Phone:	() -
Graduation Date:
Cumulative GPA:

Art Activities and Honors

List art activities (clubs, exhibits, awards, etc.)

Personal Information

How did you become involved in art, and what has it done for you?

What role do you see art playing in your future?

Recommendations

An application must include two letters of reference from individuals who are not related to the applicant. They may fill out the letter of support online or print out copies.  Printed letters of support must be mailed directly to the Figge Art Museum. List the names of the two individuals you have asked to prepare written references below.

1.
2.

Portfolio Waiver

I understand that I cannot hold the Figge Art Museum or Scholarship Review Committee responsible should works in my portfolio be damaged or lost during the review process.

Signature:
Date:	Now

Grade Notification Waiver

I understand that if I am selected as a Brand Boeshaar Scholarship recipient it is my responsibility to ensure the Figge Art Museum staff receives a copy of my official transcript at the end of each semester. Failure to do so may result in the forfeiture of my scholarship.

Signature:
Date:	Now

Security Code

Security Code: