2021-2022 Early Outreach Scholarship Application I.Personal information First name Last name Date of Birth Home address City State State - Select -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming image/svg+xml Zip Home phone Cell phone E-mail address Shirt Size Please select all Access ASU Programs you were or currently are a participant of from the following choices American Dream Academy Barrett Summer Scholars Camp Catanese Camp Catanese Cesar E. Chavez Leadership Institute Clubes de Ciencias Summer Program First Start at ASU Future Sun Devil Family Day Hispanic Mother Daughter Program (HMDP) INSPIRE Polytechnic Summer Leadership Academy RISE Leadership Institute Science and Engineering Experience (SCENE) Students Providing Awareness Resources and Knowledge to Start (SPARKS) College Summer Experience at West (SEW) Are you reapplying? Yes No II.Service hours option Please select one Access ASU Outreach Ambassador chool Partnership Ambassador Hispanic Mother Daughter Program Peer Mentor III.Academic Information High School (If current ASU student, type N/A) Current cumulative unweighted GPA University classification fall 2021 - Select -freshmansophomorejuniorsenior Intended major of study If current ASU student, 10-digit campus ID# Intended/assigned university campus - Select -TempeDowntown PhoenixWestPolytechnic Expected Graduation Semester/Year IV. Addendums Link to video Submit a digital video presentation using the following criteria: No longer than 5 minutes in length Begin With Personal introduction First time applicants: Describe one of the following topics: A personal obstacle you overcame Your biggest achievement Your professional goals Your motivation to help others Reapplying applicants answer the following: What has this scholarship helped you accomplish? And/or how has it helped you prepare for life after college? Upload your video to YouTube or Vimeo prior to submission then copy and paste the link above. Please ensure that your video is not password protected. V. Verification statement Verification I have read and reviewed this application and understand the responsibilities of the Early Outreach Scholarship (EOS). I personally prepared this application and certified that the information is accurate and truthful to the best of my knowledge. I understand that for scholarship eligibility I must meet all the criteria listed on the EOS program website. Leave this field blank