Geiman Scholars Program Application

THE GEIMAN SCHOLARS PROGRAM APPLICATION

Student Information

First Name

Last Name

Birthdate

Mobile Phone

Email Address

Are you Hispanic or Latino?

Cumulative GPA

Parent and Family Information

Parent First Name

Parent Last Name:

Parent Phone

Parent Email

Did your parent(s) or guardian(s) graduate from college?

What is your family's Adjusted Gross Income (AGI)?

Do you or your family receive any government assistance (for example: SNAP/Food Stamps, Medicaid, LEAP, Health First Colorado, Colorado Works, Free or Reduced Lunch, etc.)?

Please provide your household size:

Essay

Please write a short essay explaining why you want to attend Western Colorado University, how this scholarship would benefit you, and include your extracurricular involvement. Once completed, upload your essay below.

Essay Upload

Acknowledgements:

Acknowledgment of Tax Information Requirement: I understand that if I am selected as a finalist, I will be required to provide my family’s tax information in order to be considered for this program.

Scholarship Acknowledgement: This four-year scholarship is available to Gunnison Valley high school students. Recipients take part in a college prep program during high school and must maintain a 2.8 GPA to remain eligible.

The scholarship provides up to $15,000 per year for four years (up to a maximum total of $60,000), contingent on the Recipient’s full-time enrollment at Western Colorado University and continued compliance with the terms of the program.

Acknowledgements: By entering my name below, I acknowledge and will comply with the statements above (Please type your full name below).