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First Name*

Middle Initial

Last Name*

CWID - Campus Wide ID Number*

Local Mailing Address*

City*

State*

Zip Code*

O-Key Email*

Phone Number*

Major*

Second Major

Minor

Anticipated Date of Graduation (Semester and Year)*

List the name and provide the email address of one of your instructors here at OSU in a MATH course who has agreed to serve as a reference for you.

Please be aware that the of Department of Mathematics Undergraduate Scholarship Committee will be unable to distribute comments to students that are provided by instructors who serve as references for scholarship applicants.

Reference Name*

Reference Email Address*

Course in which reference provider was your instructor*

Semester in which that course was taken*

Please prepare a short personal statement (no more than 500 words) describing your professional and academic goals as a math major and your efforts to explore these. You may include information on related activities such as working as a tutor at the MLSC or elsewhere, independent study or research projects, internships, math club participation, or other relevant extracurricular or volunteer activities.

Personal Statement*

Please list academic honors and awards, including where and when each was earned, and other significant experiences and achievements that contribute to your overall educational goals.

Academic Honors and Awards*

Please list any other items you would like to share with the scholarship committee (no more than 500 words), including any particular personal or financial difficulties you would like us to be aware of or other concerns.

Other

Upload a copy of your OSU grade report or unofficial transcript showing all college courses you have taken (at OSU and other institutions) and grades earned.

I certify that the information that I have provided on this application and in the attached responses is accurate to the best of my knowledge. I give permission to the Department of Mathematics Undergraduate Scholarship Committee to review my OSU grade report. Furthermore, I give the Scholarship Committee permission to review my current financial aid information from the Office of Scholarships and Financial Aid if I am being considered for a scholarship with a need-based component. I understand that, if selected for an award, my progress will be monitored. If, during the 2021-2022 academic year, I am no longer a full-time student making satisfacory progress towards a major in Mathematics*, my award may be canceled.

*Exceptions are made for seniors who can fulfill graduation requirements as part-time students in their final semester.

Full Name*

Today's Date*

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