Lambda Sigma Forms
		Form 5:23: National Scholarship Application
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		Form 5:23: National Scholarship Application This form should be submitted by mail with a personal biographical statement of your background and future plans, an official transcript, three letters of recommendation from faculty or staff members and a letter of nomination from your sponsoring chapter. Deadline: May 1 Full Name: ______________________________________________________________________________________________ College/University________________________________________________________________________________________ Current School Address: __________________________________________________________________________________ Home Address: __________________________________________________________________________________________ Academic Status: (circle one)                     sophomore                          junior Cumulative Grade Point Average: __________ Major: ________________________________________________________ Undergraduate Degree to be Awarded: ____________________________________________________________________ Anticipated Date of Graduation: ___________________________________________________________________________ Career Goals: ____________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ College Activities: ________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ College Honors: __________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ Positions Held in Lambda Sigma: __________________________________________________________________________ _________________________________________________________________________________________________________ Additional Service to Lambda Sigma, the College or the Community: (please note leadership roles) _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________ _________________________________________________________________________________________________________   I certify that the above information is correct, to the best of my knowledge, and that I will report any changes of information to the scholarship committee promptly.   Date: __________________________ Signature of Applicant: ___________________________________________________ Send to: Mark Shotwell Department of Biology Slippery Rock University Slippery Rock, PA  16057-1326
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