Scholarship Application Form Page 3
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Complete Scholarship Application Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
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3Honors/Awards including dates
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
College/Community Involvement including dates
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Work Experience including dates
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
(May attach a sheet with additional honors & involvement or a Resume)
I certify the information in this application is true. Additionally, I give permission
for NYSTAA to use the information submitted, including my essay, in its
publications & website for publicity and future scholarship brochures.
Signature____________________________________ Date ____________________
For questions or more information, contact:
Melissa Moore, Bryant and Stratton College,
mmoore@bryantstratton.edu
Rebecca Mack, Monroe Community College,
rmack@monroecc.edu
The New York State Transfer and Articulation Association is a nonprofit organization dedicated to
transfer issues and transfer student educational opportunities, and does not discriminate against
race, creed, age, gender or lifestyle in membership or scholarship candidates. The NYSTAA
website can be found at
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