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The Staff Senate

The Staff Senate
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Print Name of Applicant _______________________________


Southern Illinois University Edwardsville

Use this form if you have completed FEWER than 12 semester hours of college work.

a. You must be the son, daughter, grandchild or spouse of a represented presently employed or represented retired Civil Service (excluding non-status), represented Professional Staff employee (excluding appointments of less than 50% and term appointments of less than six months), or represented Non-tenure track faculty member of SIUE;

b. You must have an overall high school GPA of at least a 2.5 on a scale of 4.0 =A; and an ACT score of 19 or above;

c. You must be fully admitted to SIUE for undergraduate study.

Eligibility Criteria: To submit an application you must meet the following criteria:

Please complete ( TYPE) the items below. You must submit all required materials in order to be a candidate for consideration.

Student ID #______________________________Daytime phone #_______________________________



Email ________________________________Overall high school or its equivalent GPA_______________

Name of SIUE represented Employee_______________________________

Unit/Department ____________________

Employment Status (check one) Presently Employed ______ Retired______

Scholarship applicants will be judged on the following criteria: Overall GPA or its equivalent, a typed essay from you, co-curricular activities (e.g. babysitting, clubs, sports, charitable service, etc.), honors and/or awards, work history, and letter of recommendation.

Applicants are required to submit: (1) a completed application, this form, (2) high school transcript, (3) ACT test results or their equivalents AND 1 (one) letter of recommendation.

Application Deadline: 12:00pm, Oct. 17, 2008
Return to:
University Governance
Box 1252
Southern Illinois University Edwardsville
Edwardsville, IL 62026
Room 0103, Rendleman Hall

Signature of applicant

In the space below, please TYPE an essay explaining why you believe you should receive a Faculty for Collective Bargaining Scholarship Award. Please include your goals and/or area of study. Use additional paper if necessary.

TYPE all co-curricular activities (e.g. babysitting, club(s), sports, charitable service, etc.). Indicate any offices held.

TYPE all honors and/or awards you have received.

TYPE Work History (paid or unpaid) # of hours dates

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