APPLICATION FOR BRILLIANCE GRADUATE SCHOLARSHIP

(Please type or print Application)

Must be postmarked or received by Noon April 12, 2013
ANY APPLICATION PACKET THAT IS NOT COMPLETE WILL NOT BE CONSIDERED.

NAME: ______________________________________________________SSN____________________________

TELEPHONE NUMBER: _________________________________________

ADDRESS: __________________________________________________________________________________

CITY: _________________________________________________ STATE ________________ZIP___________

HIGH SCHOOL FROM WHICH YOU GRADUATED: _____________________________YEAR:__________

HOW MANY SEMESTER HOURS HAVE YOU COMPLETED AT NAVARRO COLLEGE? _____________

PLEASE LIST OTHER COLLEGES AND UNIVERSITIES ATTENDED

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WHAT IS YOUR CUMULATIVE GRADE POINT AVERAGE? ______________________________________

MAJOR: ____________________________________________________________________________________

COLLEGE OR UNIVERSITY TO WHICH YOU PLAN TO TRANSFER:

MAJOR AREA OF STUDY YOU PLAN TO PURSUE: ______________________________________________

PLEASE LIST ANY ACTIVITIES OR SPECIAL RECOGNITION THAT YOU HAVE RECEIVED AT NAVARRO. (Include any
offices that you have held in campus organizations.)
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SIGNATURE DATE

January 11, 2013