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Don & Rose Kutchera Scholarship

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For a printable copy of this scholarship: Don and Rose Kutchera.

Please complete all required fields below.

Note that you cannot save and return to this form later.

First Name (Required)

Middle Initial

Last Name (Required)

UW Oshkosh Student ID # (Required)

Seven-digit campus ID number.

Home Address (Required)

PO Box

City (Required)

State (Required)

Zip Code (Required)

Phone Number (Required)

Your Email Address (Required)

High School Name (Required)

Graduation Date (Required)

If unsure of exact day, choose the date you feel might be closest.

/ /

Intended Major (Required)

Semester you plan to enter UW Oshkosh (Required)

Year you plan to enter UW Oshkosh (Required)

2013

Will you be a full-time student? (Required)

Yes
No

Briefly discuss your community service activities: (Required)

Please limit submission to 500 words.

Text Format

Briefly discuss your involvement in school extracurricular activities: (Required)

Please limit submission length to 500 words.

Text Format

Please review all information before submitting your scholarship.

You will receive a confirmation email upon completion.