2017-2018 MORRIS SCHOLARS STIPEND

One Stop Student Services 105 Behmler Hall 600 East 4th Street Morris MN 56267-2132

This form is used to request the stipend that is associated with the Morris Scholars award. Students must have completed two consecutive semesters and at least 30 cumulative credits and have a cumulative grade point average (GPA) of 2.5. The stipend must be used during the second, third, or fourth year.

320-589-6046 Fax: 320-589-1673 [email protected]

Complete this form, add the required signature in black or blue ink, and return to the One Stop. Student Information Legal Name (last, first, middle initial)

Student ID Number

Preferred Name

Preferred Telephone Number

Stipend Information Check the term that the stipend will be used:

Fall

Spring

Check the purpose for which the stipend will be used: Academic Conference Artistic Project Internship National Student Exchange (check one):

Plan A

Fall and Spring Research

May/Summer Study Abroad

Plan B

Other (explain): Morris Scholars Stipend amount requested $ _______________

Certification I certify that I will use the requested funds from my stipend for the purpose stated above. I understand that the requested amount will be disbursed to my student account and all outstanding expenses are my personal responsibility. I understand that the stipend is subject to repayment if I do not complete the approved purpose. Student Signature Date

Academic Center for Enrichment (ACE) Use Only ACE Contact Name and Title Comments:

Morris Scholars Stipend will be for credit:

Yes - Course # _______________

No

Budget Amount Approved $ _______________ ACE Staff Signature

Date

Office of Financial Aid Use Only Student has a GPA of 2.5 or above:

Yes

No _______________ GPA

Student has completed 2 or more consecutive semesters at UMM: Student has earned at least 30 cumulative credits at UMM: Morris Scholars Stipend amount available:

Yes

Yes

No

No _______________ credits

_______________

Morris Scholars Stipend amount requested:

_______________

Morris Scholars Stipend amount remaining:

_______________

Eligible

To request this form in an alternative format, please contact the Disability Resource Center at 320-589-6178 or [email protected].

Not Eligible

OFA