THE
DEPARTMENT OF HISTOY
SCHOLARSHIP APPLICATION FORM
Please Type or Print Clearly
Date__________ Student
ID#__________ Email_______________
Name and
Address_______________________________
_______________________________
_______________________________
_______________________________
Undergraduate__________ Graduate__________
Please indicate the
scholarships for which you would like to be considered:
_____Baldwin _____William and Dora Martin
_____Diley _____Dorothy Garrett Martin
_____Harris
Total number of semester
hours you have complete through the past
December__________
Semester hours completed
in history (including Humanities and World
Civ.)__________
Overall GPA__________ History GPA__________
Undergraduates, have you
formally declared a major in history?_____
Your Signature_____________________________
Received in the History
Department______________________
Please attach an essay explaining why you deserve the history scholarship(s) for which you are applying and describe your qualifications for it/them.