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George D. Dallas Leadership Scholarship

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For a printable copy of this scholarship: George D. Dallas Scholarship.

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

I attended Stevens Point area High School for at least 4 semesters (Required)

Yes
No

Briefly Discuss Your Participation In Extracurricular Activities (excluding athletics): (Required)

Please limit submission to 500 words.

Text Format

Describe Your Need For Financial Assistance:

Please limit your response to 500 words or less.

Text Format

Please review all information before submitting your scholarship.

You will receive a confirmation email upon completion.