OK-AHEAD logo

Oklahoma Association on
Higher Education and Disability

Scholarship Application

All scholarship applications and supporting materials MUST be received between November 1 and January 31 for the subsequent academic year. Incomplete applications will not be considered.

Personal Profile of Applicant

Please Type or Print in Black Ink

Name_______________________________________________________________________

Address_____________________________________________________________________

City/State/Zip_________________________________________________________________

Home Phone________________________________Cell Phone_________________________

Email Address________________________________________________________________

If applying as a graduating senior, what high school did you attend?
____________________________________________________G.P.A.____________________

List all formal education in chronological order of attendance

Career/ Technology Education _______________________________________________G.P.A.___________
_______________________________________________G.P.A.___________
Community College_______________________________________________G.P.A.___________
_______________________________________________G.P.A.___________
Four year College/ University_______________________________________________G.P.A.___________
_______________________________________________G.P.A.___________

Include verification (i.e., unofficial transcript, letter from advisor on office letterhead for all above academic information submitted)

Check all that apply:
____ I am currently a graduating senior in high school.
____ I am currently registered at a postsecondary institution.
        Name of Institution __________________________________________
____ I have been admitted and plan to register at a postsecondary institution.
        Name of Institution __________________________________________


Do you anticipate your academic plans to change within this next year? If so, please explain.

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Using the space provided, respond to the following. Do not staple or glue anything to this page.

Please name the institution where you are now enrolled or plan to enroll.

________________________________________________________________________________________

What will be your major course/program of study? _____________________________________

What will be your minor course/program of study or explain if a minor not applicable for your major?

________________________________________________________________________________________

  1. Explain why you chose this major/ minor/ program/ degree.

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  2. What are your professional/career goals and how will this chosen program/degree help achieve these goals?

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  3. Describe the impact of your disability on your educational goals and how you plan to achieve success in those educational goals.

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  4. What has been your biggest life challenge and how did you deal with it?

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  5. Please explain ways in which you have used self-advocation strategies and self-determination in the past to overcome obstacles.

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Required Signature

By my signature below, I:

  1. Affirm that I have furnished all information requested in this application;
  2. Understand that withholding information requested or giving false information may make me ineligible for the scholarship; and
  3. Agree that relevant information may be released to off-campus committees for scholarship consideration and to the news media.
____________________________________________________________________________
Signature                                        Printed name                          Date

Reminder

Completed application packets must be postmarked by January 31 of the application year. Incomplete applications will not be considered. Send applications to:

OK-AHEAD Scholarship Committee
c/o Kimberly Fields
University of Central Oklahoma
100 N. University Dr, Box 144
Nigh University Center, Rm 309
Edmond, OK 73034

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