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Northern Illinois University ETRA Scholarship Application Name Social Security Address City State Zip Code Telephone Applying for email Dr. Signature Date Send the complete scholarship application this form and required documents to ETRA Scholarship Committee ETRA Gabel Hall 208 DeKalb IL 60115 NOTE Only fully completed applications will be considered. All material must be received by the date s specified on the information sheets. James Douglas Gott Education Scholarship Robert H. Bauernfeind Memorial Scholarship Alice H. Hicks Teachers Education Scholarship Number of semester hours completed at NIU as of this date NIU cumulative GPA Level Masters degree must have completed a minimum of 15 credit hours by date of application Doctoral degree Department Degree Pursued Specialization/Emphasis Attach all supporting documents and materials e*g* essay resume etc* See the appropriate scholarship information sheet for details on required documents and materials. I certify by my signature that the information herein is true and accurate and I give the committee permission to access my transcript of courses. James Douglas Gott Education Scholarship Robert H. Bauernfeind Memorial Scholarship Alice H. Hicks Teachers Education Scholarship Number of semester hours completed at NIU as of this date NIU cumulative GPA Level Masters degree must have completed a minimum of 15 credit hours by date of application Doctoral degree Department Degree Pursued Specialization/Emphasis Attach all supporting documents and materials e*g* essay resume etc* See the appropriate scholarship information sheet for details on required documents and materials. I certify by my signature that the information herein is true and accurate and I give the committee permission to access my transcript of courses..

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