Number of fall and spring semesters at SIU Carbondale.
Month and year you began current degree program
Month and year you expect to finish current degree program
Total credit hours earned at SIU Carbondale.
Monthly Income Questions - Complete the following questions regarding your average income per month by source:
1. Family/Friends/Personal Savings
2. Scholarship/Sponsoring Agency
3. Student Work/Other Assistance from SIU Carbondale
4. Other Sources
5. If you specified income from a scholarship or sponsoring agency or other source not listed here, please specify the source here.
If you have held a job while at SIU, please list where, what semesters, and how many hours you work(ed):
What is your monthly rent payment?
How many dependents do you have living with you? If none, select zero (0).
Vehicle Questions
1. Do you own a car?
2. If yes, list the make, model, and year.
3. Do you have a special need for this car? Please discuss.
Have you received any financial awards from SIU? If so, please provide details of the award, including the award amount and semester you received the award(s)
Please discuss any other pertinent information about your financial resources and obligations that might be helpful in assessing your need.
I hereby declare under penalty of perjury that the foregoing information is true and correct. I am fully aware that any intentional falsification of information contained herein may result in denial of the application and further that this scholarship may be revoked if I fail to meet the designated requirement of being enrolled full time for the next academic semester.
