Scholarship Appeal Form

Note: All fields marked with an asterisk (*) are required for form submission.

First Name*

Last Name*

Email Address*

Birthdate*

Net ID (if known)

Please select all items that apply.

I’m submitting new SAT/ACT scores that were not originally included with my application.

I’m submitting improved grades and/or mid-year grades that were not originally included with my application. NOTE: Grades must be received on an official high school transcript.

I'm providing a list of courses in progress that were not originally included on my transcript.

I’m submitting an essay that was not originally included with my application.

I’m submitting a new letter of recommendation that was not originally included in my application.

I’m submitting activities not originally included on the application.

Personal statement of extenuating circumstances (if not originally listed on the application).

I’m submitting new SAT/ACT scores that were not originally included with my application.*

My school counselor will submit my SAT/ACT scores.

I am submitting a request to the College Board to send my SAT scores.

I am submitting a request to ACT to send my ACT scores.

I’m submitting improved grades and/or mid-year grades that were not originally included with my application.*

NOTE: Grades must be received on an official high school transcript.

My school counselor will submit my official high school transcript.

I'm providing a list of courses in progress that were not originally included on my transcript.*

My school counselor will submit a transcript with updated courses in progress.

I’m uploading an unofficial transcript with my list of senior year courses in progress.

I will provide a list of my senior year courses in progress on this form. Include Course Title and Units attempted (e.g. English 12, 1 unit).

Upload your unofficial transcript here:

Please enter your senior year courses in progress here:

Course #1 Title

Course #1 Unit Count

Course #2 Title

Course #2 Unit Count

Course #3 Title

Course #3 Unit Count

Course #4 Title

Course #4 Unit Count

Course #5 Title

Course #5 Unit Count

Course #6 Title

Course #6 Unit Count

Course #7 Title

Course #7 Unit Count

Course #8 Title

Course #8 Unit Count

Course #9 Title

Course #9 Unit Count

Course #10 Title

Course #10 Unit Count

I’m submitting an essay that was not originally included with my application.

I am uploading my essay.

I will write my essay on this form (500 words or less).

Upload your Essay here:

Please type your Essay here:

I’m submitting a new letter of recommendation that was not originally included in my application.*

My recommender will be submitting the letter of recommendation on my behalf.

I am uploading the letter(s) of recommendation to this form (you may submit 3 via this form).

Please upload Letter of Recommendation #1 here:

Please upload Letter of Recommendation #2 here:

Please upload Letter of Recommendation #3 here:

The following recommenders will be submitting letters for me:

Recommender 1 First and Last Name

Recommender 2 First and Last Name

I’m submitting activities not originally included on the application.*

NOTE: NCAA Division III Bylaws prohibit the awarding of financial aid awards, grants, and scholarships to intercollegiate student-athletes on the basis of athletic participation, leadership, ability, or performance. As a result, eligibility for scholarships will be assessed without the consideration of athletic participation, leadership, ability, or performance.

I am uploading my resume of activities (include activity type, activity description, years participated (e.g. 9th, 10th), and hours per week).

I will submit my resume of activities on this form. I understand that athletic participation, leadership, ability and performance are not considered in the scholarship review process.

I understand that athletic participation, leadership, ability and performance are not considered in the scholarship review process.

Please upload your resume of activities here:

Please input your resume of activities below:

Activity #1

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #2

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #3

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #4

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #5

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #6

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #7

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #8

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #9

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Activity #10

Activity Type

Activity Description

Years Participated

9th

10th

11th

12th

Hours Per Week

Personal statement of extenuating circumstances (if not originally listed on the application).

I am uploading my personal statement.

I will submit my personal statement on this form (500 words or less).

Please upload your Personal Statement here:

Please type your Personal Statement here:

I understand that this is a legal representation of my signature and that the information provided on this form is not falsified in any way (please type full name):*

Date*