Dietetics Scholarship Application All fields marked with an asterisk (*) are required. "*" indicates required fields Name* First Last Age*Please enter a number from 1 to 150.Student ID number*(7-digit) Phone*(###) ###-####Email* Permanent (Home) Mailing Address*Are you a U.S. citizen?* Yes No Are you a first-generation college student?* Yes No Check those that are appropriate.* Black Hispanic Native American White Asian Multi-racial Other Year in Graduate program* 1 2 3 4+ Expected Graduation Date* Awards/Recognitions/ScholarshipsAdd more rows for multiple awardsOrganization or EventAward/Recognition/ScholarshipHigh SchoolCollegeDate(s) Add RemoveUndergraduate Research ExperienceAdd more rows for multiple experiencesOrganization/DepartmentResearch ExperienceSupervisor/ManagerDate(s) Add RemoveVolunteerism and Community ServiceAdd more rows for multiple servicesOrganization or EventDescription of Services ProvidedHigh SchoolCollegeDate(s) Add RemoveExtracurricular Student ActivitiesThis DOES NOT include Athletic Participation (see separate listing below), but instead Clubs, Associations, Organizations, etc. "Level of Participation" corresponds to member, president, etc. Add more rows for multiple activities.Organization or EventLevel of ParticipationHigh SchoolCollegeDate(s) Add RemoveLeadership Positions HeldAdd more rows for multiple positionsOrganization or EventLevel of ParticipationDate(s) Add RemoveAthletic Participation at UConnVarsity, club or intramural. Add more rows for multiple activities.ActivityLevel (varsity, club, intramural, other)Date(s) Add RemoveWork & Internship ExperienceAdd more rows for multiple awardsEmployer/LocationPosition TitleDutiesDate(s) Add RemoveCertifications ObtainedAdd more rows for multiple certificationsOrganization/DepartmentName of CertificationSupervisor/ManagerDate(s) Add RemoveAre there any special circumstances or hardships impacting your financial need that you would like the Scholarship Selection Committee to be aware of when considering scholarships?*Please be aware that this information is kept confidential, therefore please feel free to explain as needed.What percent of your educational costs (including tuition, fees, books, housing, board, etc.) are you responsible for covering? Please provide any information that can help the scholarship committee assess your financial need.*Do you work during the semester?* Yes No Please estimate the number of hours per week worked. Do you plan to travel internationally or participate in an Education Abroad Program through UConn within the coming year?* Yes No Please describeEssay*Describe your educational and career goals. (approximately 250-300 words)Resumé*Accepted file types: pdf, doc, docx, Max. file size: 10 MB.College Transcript*Accepted file types: pdf, doc, docx, Max. file size: 10 MB.UConn Graduate TranscriptAccepted file types: pdf, doc, docx, Max. file size: 10 MB.Agreements*1) To the best of my knowledge, I verify that the information I have provided on this scholarship application is accurate. 2) I give my permission to the Scholarship Selection Committee to share relevant information on my application with the donor/organization/society/association if I am selected as a recipient of their scholarship. 3) I understand the relevant information may include my academic standing, grade point average and/or other qualifications relevant to their scholarship criteria. 4) I understand that if I am selected for a scholarship and there is a living donor/family member, etc., that I must write a letter/note of thanks within two weeks of receiving the scholarship/award notification. 5) I understand as a scholarship recipient that if I do not provide a thank you within the two weeks of receiving scholarship/award notification, I may jeopardize losing my scholarship. I have read and understand eligibility requirements.Important Note! Please be aware that you need to select one of two options below to continue, however it is important that you read the choices carefully before making your choice, because once you select the option to “Submit” you will NO LONGER have access to add/edit your scholarship application: If your scholarship application is INCOMPLETE, or you think you will need to change or update your submission before the deadline, please choose the “Save and Continue Later” option at the bottom of the form. If your scholarship application is COMPLETELY DONE, and you DON’T NEED to add/edit anything else to the application you can choose the “Submit” option. Please note: After you hit the “Submit” option you will no longer be able to make changes to your scholarship application. Therefore, if at a later point before the Scholarship Application deadline, you want to add/edit something to your application, you will have to complete the entire scholarship application form again from the beginning. Only the latest version of your scholarship application submission will be considered. Thank you and don't forget to proofread your scholarship applications before submitting!PhoneThis field is for validation purposes and should be left unchanged.