MSEED Scholarship Day Application

To apply for the MSEED Scholarship Day 2015 at Valparaiso University on Friday, February 13, 2015, please complete the form below.

Application Deadline is February 4, 2015. Capacity is limited.

All of the following fields are required to submit the form. There is a required essay requested at the end of the registration form.

First
Last
Preferred Name

Street Address
City
Zip
Cell Phone #
Email

Full name of parent(s)/guardian only if participating in MSEED Scholarship Day at Valpo — limit 2 per student

Please list any food allergies:

Intended Major:

Please select one of the following classes to attend:

Would you like to spend Thursday night with a Valpo student host?

Please indicate your status with Valparaiso University below:

I have applied to Valparaiso University.

I have been admitted to Valparaiso University.

I am currently attending Valparaiso University


List three hobbies or interests that would tell us more about you.





Required essay: People choose to become teachers for a variety of reasons.

Tell us about an inspirational figure, defining moment, or other reason that

has impacted your decision to pursue a career as a math or science teacher?