附件4：西亚斯基金会公益使者奖学金申请表.docVIP

附件4（勿改申请表格式） 公益使者奖学金申请表 学院 系 专业 班 个 人 信 息中文名拼音照片英文名学号性别出生年月学制□ 二年 □三年 □四年年级□ 2012级 □2013级 □ 2014级学位西亚斯学位 □ FHSU学位 □ 双学位Email联系电话寝室地址中方成绩平均分美方成绩平均绩点家 庭 信 息姓名年龄与本人关系工作单位家庭详细地址家庭电话邮政编码同 学 意 见同学意见 签名：室友意见 签名：班长意见 签名：辅导员审 核 意 见 签名： 年 月 日外 教 意 见 签名： 年 月 日专业学院、系 审 核 意 见 签名： 年 月 日 申请理由： 签名： 年 月 日Ambassador Scholarship Application Form School Dept. Major Class Scholarship Category: Sias Foundation Ambassador ScholarshipChinese Name Pinyin Name PhotoEnglish Name Gender Student ID Date of BirthE-mailPhoneDegree□ Sias degree □ FHSU degree □ BothGrade □ 2007 □ 2008 □ 2009Grade Level□ Bachelor □ Associate of Arts □ Bridge studentAverage Score for Sias DegreeGrade Point Average for FHSU DegreeWhat are your goals after you graduate from SIAS? How would you describe your strongest character traits? What activities outside of class are you involved with at SIAS (e.g. , band,debate club, English club, sports, art or community service project) What class or person has had the most impact on you this year and how did it impact your interest in learning? Brief Introduction of your family. How will winning this award help you to be successful?? Of the activities or service you have done, please give an example of how you demonstrated leadership qualities in working with that group. Please attach a recommendation letter from a faculty member.