Undergraduate/Graduate (SUMMER) Application 2023-2024

Stein, Kylie

Applicant View

Personal Information

Personal Information

*Bellevue University Student ID #:

*First Name:
Middle Name:
*Last Name:
Country of Citizenship:
Immigration Status:
*Immigration Status, please state:
*Address 1:
Address 2:
Address 3:
Address 4:
*City:
State:
*Zip Code:
State of Permanent Residency:
*Where were you born (City and State)?
Home Phone:
Cell Phone:
Work Phone:
*Email Address:
*Gender:
Ethnicity:
*Ethnicity, please identify:
*Date of Birth:
*Marital Status:
*Number of Dependent Children:
*Are you a descendent of a Vietnam War Era Veteran?
Military Affiliation:
Military Status:
Military Spouse:

Academic Information

Academic Information

*Are you pursuing a courses or a degree through Guild Education or

are you receiving Bellevue University Tuition Remission or are a
part of the Tuition Exchange Program from your employer or your
parents' employer?
*Are you pursuing courses or a degree as part of your employer's
Campus@Work tuition assistance program?
*Are you a first generation college student?
*Which type of education are you planning to or are currently
enrolled in to pursue?
*Are you pursuing your first Bachelor's or Master's degree?
*Are you planning to enroll full-time for the Summer 2024 term at
Bellevue University?
*If you are not planning to enroll into full-time courses for the Summer term at Bellevue University, please explain why.
*Beginning with the 2023/2024 Academic Year Term, what is your
current student type:
Transfer Credits Earned:
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Previous Non-BU Degrees Earned:

*College:
*Academic Career:
*Academic Plan Description:<br />
*Are you pursuing a minor in Arts & Humanities? If so, please
indicate which you have declared.
*Are you planning to pursue a career in Athletic Training?
*Have you spoken directly to Mike Livergood, Head Athletic Trainer
for Bellevue University about your interest in pursuing a career in
Athletic Training?
*Are you planning to pursue a career in the legal field (i.e. paralegal,
attorney, etc.)?
*Student Grade Status:
Cumulative GPA:
Total Earned Credits:
Previous BU Degrees Earned
Date Degree Conferred

Academic Awards/Recognition received

*Have you received any academic awards or recognition?

Financial Information

Financial Information

*If you are an U.S. citizen, legal permanent resident, or eligible non-
citizen, have you completed and submitted your 2023-2024 FAFSA
(application for financial aid) to the Financial Aid Office yet?
*Are you an international student, DACA student, and/or another
type of student not eligible to complete the FAFSA?
*Since you are unable to submit the Free Application for Federal
Student Aid (FAFSA), did you submit the Federal Student Aid
Estimator through the Federal Student Aid's website here:
https://www.studentaid.gov/aid-estimator/ in order to document your
financial need?

NOTE: Most scholarships offered at Bellevue University are needs based, therefore students
will need to submit a FAFSA to determine eligibility for need
Estimated Family Contribution (EFC) from the FAFSA:
FAFSA Application Year:
*Check additional sources of educational funding.
Are you planning to or currently residing in Bellevue University
Campus Housing?

Employment Information
*Are you currently working or planning to work at a government or
non-profit agency/organization?
*Employment Status 1:
*Employer Name:
*Job Title:
*Add another Employment Status?
*Applicant's Annual Income:
*Applicant's Annual Household Income:
*Some organizations may have paid internships available as part of
their scholarship package. Are you interested in being considered
for an internship-scholarship?DISCLAIMER: By checking yes, this
does not guarantee an internship position with any company or
organization participating in the scholarship program.

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Activities

Activities
*Are you a current "active" TeamMates mentee?
*Have you participated in any activities within the last academic
year? This includes anything outside of paid employment to include
participation in: clubs, sports, organizations (including professional
organizations), memberships, community involvement and/or
community service.
*If no, please describe your commitments outside of school over the last academic year that have prevented your involvement in any type
of activity.

Please list up to three (3) activities you participated in throughout the last academic year,
highlighting the time frame you were involved with the activity, any leadership roles held, and
how it was impactful on your life.
*Name of Activity/Club/Organization:
*Year Involved:
*Indicate position held:
*In a few sentences, tell us in your own words, how your participation was significant or how it changed your perspective.
*Add another activity:

Attachments

Attachments

Upload a copy of your FAFSA Student Aid Report (SAR) OR

Federal Student Aid Estimator :
*I confirm that I have uploaded all document(s), if required:

Fund Eligibility

Fund Eligibility
*Based on the information provided in your application, click on
“Update List” to see the list of funds that you are eligible for. If no
funds populate, you are not eligible for any at this time. Please
check back at a later date to determine if new funds are available.
At that time you will be able to fully submit your application for
review.

Essays

Essays

*REQUIRED ESSAY: In 500-1000 words, how would you describe your current stage in life? What unique challenges are you facing?
What actions are you taking to overcome these challenges? (Do NOT include your name in your essay response).

For the following short-answer essays, please write the question you are choosing to answer
into the essay box first, then type in your response.

Do NOT copy/paste the question from the application. The formatting is causing issues that is
affecting the html coding and causes your responses to disappear after you leave the site.
*CHOOSE 1 OF THE FOLLOWING TO ANSWER:1. In 200-300 words, describe what keeps you motivated while working on a difficult
goal or project? What tools or methods do you use to keep from quitting?OR2. In 200-300 words, What is the hardest you have ever
worked on something in your life? Why did you decide to invest your efforts in this endeavor?(Do NOT include your name in your essay
response).
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*CHOOSE 1 OF THE FOLLOWING TO ANSWER:1. In 200-300 words, describe a time when you stepped up in a group setting in which
no one was acting. What did you say? What actions did you take? What was the result? OR2. In 200-300 words, describe a time when
you stepped into a leadership role within your family, at work, or in school. What did you accomplish? What did you learn about yourself
as a leader?(Do NOT include your name in your essay response).
OPTIONAL: Other Pertinent Information: Please include any additional information you would like to share with the Bellevue University
Scholarship Committee as they review your application. (Do NOT include your name in your essay response).
*Please indicate how you learned about scholarships and grants
offered at Bellevue University? (Check all that apply).

Authorization and Release

Authorization for Recommendations

The Family Educational Privacy Act of 1974 and its amendments guarantee students access to their educational
records. Students are permitted to waive their right of access to recommendations, thus allowing the
recommender to write in confidence.
The following statement indicates the wishes of the applicant regarding recommendations.

*As an Applicant, do you waive the right to review recommendations

(if needed as part of the application process), which shall therefore
be considered confidential.

If the applicant waives the right to review recommendations, he/she will not be allowed to inspect the contents of
the online recommendations.
Note: Some recommenders will only write confidential letters.

Release of Application Contents

*I agree to release all contents of my application, including

attachments and acceptance information for scholarship donor and
board reporting.
* I agree that if I am awarded a scholarship, my name, photo and
likeness may be used for donor and board reporting for the
scholarship(s) I have received.
*I agree/disagree that if I am awarded a scholarship, my name,
photo, any video testimonials, and likeness may be used for
promotional purposes on the Bellevue.edu website, in both print and
web marketing materials, and via submitted testimonial videos.
* I understand that the information provided in this application is
considered a confidential educational record under federal privacy
laws. However, limited exceptions may be made in cases of health,
welfare, or safety. I understand that any information I provide that
indicates potential harm to the health, welfare, or safety of myself or
others may be shared as allowed by law.

Additional Application Acknowledgements

*I agree that all the information provided in this application is true to

the best of my knowledge, my words are my own, and I understand
that falsifying or plagiarizing any information may disqualify me from
receiving scholarships.
*I confirm that I have reviewed the contents of my application and
updated any information accordingly before submitting my
application for review.
*I understand that in order for my scholarship application to be
officially submitted, I must click on the "Final Review and Submit"
button on the dashboard, before the application deadline
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*Applicant's signature:
*Date:

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