Beth Morris Scholarship Application - Wild Rockies Field Institute

Name*

First Last

Email*

Phone*

Amount of Funding Requested

Family & Financial Information

If you applied for Financial Aid this academic year, you must attach a copy of your Student Aid Report (SAR), including your EFC score. You can download a copy at: www.fasfa.gov.

Adjusted gross income for past calendar year:

Your parent's adjusted gross income for past calendar year:

Tuition Information & Financial Resources

For current academic year

School tuition & fees

Living (housing, food)

Other major expenses (specify)

Please help us understand how you pay for your school and living expensive. Indicate specific income amounts for each of the following categories:

Work	Savings	Investments	Parents/Family	Other

Did you apply for financial aid or scholarships at your school or elsewhere?*

Yes
No

Financial Aid & Scholarships from your school or an outside source (specify amount and type)

Other Details

Detail here any special financial circumstances affecting your situation: medical costs, obligations to support others etc. Use back of paper if necessary. I certify that the information supplied in this application is correct.

Project Proposal

After reading the Cycle the Rockies course description, please provide a brief summary of the issues you hope to address through your media project:

Explain the type of creative format (video, photography, other visual arts, written work, or combination of these modes) you propose using:

As part of your application materials, you may provide an example of past media-related creative work. Please note that the type of media proposed does no need to be of the same format as your sample. If providing an example of past work, please explain the context of the sample:

Sample of Work

Applicant Signature*

Date*

Name

This field is for validation purposes and should be left unchanged.