Civil Engineering Scholarship Application
Scholarship Application
The American Society of Civil Engineers, Michigan Section
Engineering Scholarships for Civil Engineering Students
Return completed application and a copy of the students’ current transcript to the ASCE Michigan Section by Memorial Day.
Applicant Information Name:
Home Address:
Home Phone: Email:
Are you a US Citizen and a Michigan Resident? Yes No
Are you a student member of ASCE? Yes No
Are you attending a Michigan School?
Best way to contact applicant? (select all that apply)
Yes No
Phone E-mail
Are either of your parents members of ASCE? Yes No If yes, what is his/her name?
Parent's Branch affiliation: Scholarship Information
I would like to be considered for the following scholarships:
Mackinac Scholarship (must be entering Junior year in the fall of the year applying) Zuidema Scholrship (must be entering Junior or Senior year in the fall of the year applying) College Enrollment History
Fall Spring Summer
University/College Academic Year Semesters Attended Course of Study
Fall Spring Summer
University/College Academic Year Semesters Attended Course of Study
Fall Spring Summer
University/College Academic Year Semesters Attended Course of Study
Civil Engineering Scholarship Application Financial Information
Estimated Expenses for the Upcoming Year Tuition (including Fees):
Room & Board (including Rent, Utilities, Food, etc.): Other (including transportation, insurance, etc.): Financial Support for the Upcoming Year
Family Contribution: Student’s Contribution:
Other Scholarships: Describe:
Student Loans: Describe:
Grants: Describe:
Other: Describe:
Other Information Relevant to your Financial Need:
Activities and Honors
Civil Engineering Scholarship Application Describe participation in non-technical activities and leadership positions held (Athletic Teams, Band, Student Government, etc.):
Describe academic honors, awards, recognitions, or special achievements (Dean's List, ASCE Awards, etc.):
Describe paid employment during the school year, including weekly hours and duration of employment:
Describe summer activities and summer employment, including weekly hours and duration of employment:
Civil Engineering Scholarship Application
Authorization
I hereby authorize officials of my university to provide information concerning my academic records to ASCE. I hereby grant permission to ASCE to release information contained herein to other potential sources of scholarship assistance for engineering studies. I certify that all statements contained herein are true.
Applicant's Signature Date
Statement of Accuracy
I hereby certify that the financial information provided in support of the applicant's statement of financial need is true and accurate and complete.
Signature of Parent or Guardian Date
University Official/Professor/Faculty Advisor Certification
I hereby certify that the academic information and summary of activities as submitted in this application are correct and that the applicant meets the eligibility requirements as outlined.
Printed Name Title
University/College Phone Number
Signature Date
Required Attachment
Please attach a current university transcript. Recommended Attachments