APPLICATION

Excellence Scholarship of NWA Application

Scholarship awarding $1000 per academic year for 2 years.
APPLICANT INFORMATION
FATHER’S INFORMATION
MOTHER’S INFORMATION
OTHER FAMILY MEMBERS CURRENTLY ATTENDING COLLEGE
HIGH SCHOOL INFORMATION
POST SECONDARY SCHOOL INFORMATION
WORK EXPERIENCE
Please list your paid work experience from the past four years, beginning with the most recent position.
SCHOOL ACTIVITIES & PUBLIC SERVICE
Please list extracurricular activities and public service or volunteer work you have participated in during the past four years in order of importance to you.
REFERENCES
Please list three non-relative references to contact on your behalf.
QUESTIONS FOR APPLICANT
ADDITIONAL INFORMATION REQUESTED
CERTIFICATION
DISCLAIMER - The Excellence Scholarship of NWA shall not discriminate against any applicant on the basis of any applicable protected classification including, but not limited to: race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in the selection of a scholarship recipient. Any related parties to board members or substantial contributors to The Reutzel Foundation, Inc. shall not be considered.

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224 S. 2nd Street
Rogers, AR 72756

Phone: 479-621-0006

email: info@reutzelfoundation.org