Application for the Father Lachowsky Scholarship

The 痴汉俱乐部 Foundation, Inc.
College of Education

Spring Deadline: Application must be received by April 1.

Spring Award: To be determined

Scholarship Criteria: Field of Special Education (BSE/MSE) Priority will be given to students currently enrolled on Special Education Masters Program.

Selection is based on academic performance.

Note: Only recipient will be notified

Name * First Last
Student ID (Example: B012345678) *
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Telephone * - (###) - ### ####
Cell Phone * - (###) - ### ####
Email Address *
Major *
Degree M.S.E. B.S.E.
Major GPA *
Cumulative GPA *
Total Number of Hours *
Total Number of Hours earned at UCA *
Parents / Guardians (if applicable)
Parents / Guardians Address (if applicable)
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Explain need for scholarship. *