Financial Aid: Scholarship Form

Financial Aid: Scholarship Form

Form Name
Office of Student Financial Aid
2002 Rollins Hall • Norfolk, VA 23529 • (757) 683-3683
This form is for all degree seeking students who plan to attend or are currently attending Old Dominion University. This form is used to select recipients for annual and endowed scholarships offered by ODU. It is only necessary to complete this form if you meet any of the criteria listed below.
Name Name * First Last
University Identification Number (UIN) *
ODU Student Email *
Estimated Graduation Date Estimated Graduation Date * / MM / DD YYYY
Scholarship Opportunities

♦ Scholarships may be awarded to students who did not complete this form, where the below-named criteria are not a factor.
♦ ODU is an equal opportunity, affirmative action institution. Minorities, women, veterans and individuals with disabilities are strongly
encouraged to apply.
Check all scholarships you'd like to be considered for and meet the criteria.

Check all scholarships you'd like to be considered for and meet the criteria. Prior Resident of Hope Haven Home (FAHH) Member of the military or a relative of a military member. (MAAD) Dependent of active duty military personnel (MADP) Honorably discharged from U.S. Armed Forces (FAAS) Participate in extra-curricular activities, such as civic, sports, drama or student government activities (FAAC) Have held a leadership position in any clubs or organizations (FALD) Work on a high school, community or university publication (FAPB) Member of Delta Sigma Lambda Sorority (FADS) Member Pi Sigma Epsilon (FAPS) Participant in university athletic program (intramural, club or intercollegiate) (FAAT) Member of Kappa Delta Rho (FAKD) Member of clubs and societies in the College of Engineering and Technology (FACE) Graduate of Old Dominion University’s Lamberts Point Summer Program (FALP) Member of high school CHROME club (FACH) Son or daughter of Old Dominion University alumnus/alumna (LGCY) Dependent of Old Dominion University faculty or staff, undergraduate was/will be claimed on parents’ taxes (FADO) Child of VSPE member (FAVS) Parent or grandparent is affiliated with Freemason Street Baptist Church (FAFS) Physically disabled (FAPD) Blind (FABL) Have completed a considerable amount of non-paid volunteer hours (FNPV) Resides or has resided in a Norfolk Redevelopment & Housing Authority property (NRHA) Student, mother, grandmother or aunt is a member of Beta Sigma Phi (MBSP) Graduate of the “Achievable Dream Program” in Newport News, VA (ACDR)
Draw your signature into the box below. *

Draw or Type

I certify that the information I have provided on this application is true and complete to the best of my knowledge. I understand that information about me known to the Admissions and/or the Registrar’s Offices may be used to evaluate my eligibility for a scholarship and I authorize those offices to release information to appropriate scholarship committees. I further authorize release of my application to third parties for the purpose of scholarship consideration. If selected for a scholarship, I authorize release of biographical information for use in publicity related to the scholarship program. I further agree that I will notify the Office of Student Financial Aid of any changes (major, residence, etc.) which may affect my eligibility for a restricted award.

Clear

Full Name

I certify that the information I have provided on this application is true and complete to the best of my knowledge. I understand that information about me known to the Admissions and/or the Registrar’s Offices may be used to evaluate my eligibility for a scholarship and I authorize those offices to release information to appropriate scholarship committees. I further authorize release of my application to third parties for the purpose of scholarship consideration. If selected for a scholarship, I authorize release of biographical information for use in publicity related to the scholarship program. I further agree that I will notify the Office of Student Financial Aid of any changes (major, residence, etc.) which may affect my eligibility for a restricted award.