Premier Scholarship Application Form Montana
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1
2Montana Premier Scholarship Application
By completing this application, you will be considered for MSU Premier scholarships which will be available to incoming
Montana resident students. The priority application deadline is 2/1 for fall semester! Apply early. Funds may be limited.
Send to: Office of Admissions, P.O. Box 172190, Montana State University, Bozeman, MT 59717-2190. If you have
questions, please call (406) 994-2452 or 1-888-MSU-CATS. Incomplete applications will not be considered.
Applicants must apply for admission and have ACT and/or SAT scores sent directly from the testing company.
PLEASE TYPE OR PRINT IN BLACK INK.
1. Legal Name
__________________________________________________________________________________________
Last
First
MI
Social Security No.
2. Home Address/Phone
__________________________________________________________________________________________
Address
City
State
Zip
Phone Number (____)______________ E-mail Address____________________________________________
3. Will you be a new freshman or transfer? ______________________________________________________________________________
4. High School/College
__________________________________________________________________________________________
Name
City/State
Zip
5. Family Alumni
Do you have a member of your immediate family who is an alumni of MSU in Bozeman? Yes No
If yes, what is your relationship? (i.e., brother, mother, etc.)___________________________________________
6. College Choice
Agriculture Arts & Architecture Business Education, Health & Human Development
Engineering University Studies Nursing Letters & Science
7. Intended Major
__________________________________________________________________________________________
(For those who are unsure, “Undecided” is an acceptable answer.)
8. Place of Birth
City_____________________________ State_________________Date of Birth__________________________
9. Citizenship/Residency
Montana Resident? Yes No
10. Race/Ethnic Backgroud African American American Indian/Alaskan Native Asian/Pacific Islander
Caucasian
Hispanic or Latino (reply optional)
/White Non-Hispanic
11. FAFSA
Do you plan to submit the FAFSA to be considered for financial aid? Yes No
12. Class ranking and tests scores
Cumulative (unweighted) GPA____(A=4.00)
Size of graduating class_____ Rank in class_____ Graduation date_________
ACT: Composite score:_____ Date tested_________
SAT: CR____ Math____ Writing____ Combined_____ Date tested________
13. Signature
By signing below, I confirm the accuracy of the enclosed information and understand that any false or
misleading statements may invalidate my application.
___________________________________________________________________________________________
(Signature)
(Date)
Leadership:
Elected position (e.g., student council, class officer, club, organizations, etc.)
Organization
Position Held
Describe Responsibilities
Monthly Hours
Grades (9 - 12)
for fall semester
February 1st, 2014 is the priority deadline for scholarship applications
. Applications received after this dead-
line may not be considered. Please apply early.
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