General Scholarship Application Form Page 3
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3Scholarship essay(s)
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________________________________________________________________________________
________________________________________________________________________________
Applicants must print name here
I hereby certify that all of the information in this scholarship request form is accurate and complete.
I understand that all the information contained in this form will be treated confidentially and will be
used for institutional purposes only. If awarded a scholarship, the organization may utilize this
information for academic purposes.
Applicant name ________________________________________ Date ____________________
For Office Use Only:
GPA: _________
Credits:_________
For further information please contact:
Scholarship Office
250 Bedford Park Blvd. West
Bronx, NY 10468
Shuster Hall room 205
718-960-8382
scholarship.office@lehman.cuny.edu
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This form should be submitted only once.
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