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Emporia State University - Kansas City
School Counselor Center
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School Counseling Scholarships
You may use the print form
here
, or submit the online form below.
Name:
Date of Application:
Address:
Current Classification:
Phone Number:
Undergraduate GPA:
Graduate GPA (if applicable):
Degrees
Degree 1:
Date Received:
Institution:
Degree 2:
Date Received:
Institution:
GRE Completed Date:
GRE Score (V+Q):
Miller Analogies:
Miller Analogies Score:
Undergraduate Major:
Undergraduate Minor:
Graduate Major (if applicable):
All applicants will be considered for the Harry J. Waters Scholarship and for scholarships offered for your specialization area only.
Employment
Current Employer:
Current Job Title:
Past Employer:
Past Job Title:
References
Reference 1 Name:
Reference 1 Address:
Reference 1 Phone Number:
Reference 2 Name:
Reference 2 Address:
Reference 2 Phone Number:
Reason for seeking a scholarship from the Department of Counselor Education:
Semester that I intend to be a full-time student and wish to be considered for a scholarship (semester and year):
Fall
Spring
Summer
Year 20:
AFFIRMATION OF NEED AND INTENT TO REPAY
Initials
Date:
Captcha
Validation Image:
Submit