Date of Application *
Date of Birth *
Phone *
Email *
I plan to pursue an educational program in the field(s) of: *
I have submitted applications to the following schools, colleges/universities and have met their requirements for admission: *
List academic honors and date(s) received:
Provide documents of your GPA, SAT, ACT, GRE, LSAT, GMAT and/or MCAT scores as applicable: *
List school organizations in which you were an active member. Indicate the length of membership and any offices held in the organization. Include all clubs, athletic teams, performing arts groups, student government and service groups. *
O. Douglas Schumann, following an accomplished naval career and successful business career and strong commitment to his community, established an endowment to provide residents of Sandoval County financial assistance for educational assistance for those wanting a better life. As a scholarship recipient, how do you plan to give back to your community now or in the future? *
List all volunteer service performed with non-school groups. Provide dates of participation and indicate any leadership role in the group. Include church/religious activities, political, civic, youth and service organizations. *
List employment during the past 4 or 5 years. Indicate the employee position(s) you held, the dates and a brief description of duties: *
Identify those individuals legally responsible for you, such as your parents, guardian or other designated person: *
List the scholarships, grants and other financial aid applied for including the amount and status: *
Estimate your total expenses for the first semester, year or term of your education. Show a summary budget including books, fees, tuition, transportation and other education expenses. *
What additional financial sources are available to you for payment of tuition and expense which have not been previously indicated: *
What have you saved for your education and what have you done to earn it? *
Please describe any circumstances which might impact your ability to finance your education. *
List the name and age of all siblings and other members of your immediate family, and indicate your relationship to each of the named individuals.
Where do you see yourself in five years and what are your goals to get there? *
Identify two individuals who can vouch for your character and confirm purpose for educational and career plans. Provide name, address, and telephone number for each reference. Be sure to make each individual aware that you have listed him or her as a reference since the scholarship committee may contact them. *
Parent or Guardian Address