University Staff Club

Graduate Scholarship Application
Eligibility: All graduate students who, preferably (but not limited to) have an undergraduate
degree from USC and are currently enrolled in a USC graduate program. Criteria for selection
include academic record, financial need, activities, service and future goals. All information will
be verified.
NAME_______________________________________________________________________
MAILING ADDRESS___________________________________________________________
PHONE_____________________________MAJOR & DEPT___________________________
E-MAIL ADDRESS_______________________________USC ID#______________________
UNDERGRADUATE COLLEGE__________________________ GRADUATION YEAR____
MARITAL STATUS_______________________SPOUSE'S INCOME____________________
NUMBER OF DEPENDENTS_________________
EXPECTED ANNUAL EXPENSES: RENT__________UTILITIES______PERSONAL______
TUITION_____________BOOKS AND SUPPLIES _____________ ADD’L _______________
ANNUAL INCOME (ITEMIZE):
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University Staff Club Graduate Scholarship Application (cont.)
EXTRACURRICULAR ACTIVITIES (NO MORE THAN 3 LINES)
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HONORS AND AWARDS (NO MORE THAN 3 LINES)
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EDUCATIONAL OBJECTIVE (NO MORE THAN 3 LINES)
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PLANS FOR THE FUTURE (NO MORE THAN 3 LINES)

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Any Additional Information You Consider Pertinent With Respect to this Application
(NO MORE THAN 3 LINES)
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Submit applications beginning Monday February 6, through Monday
February 20, 2012.
3:00 P.M. to the Scholarship Committee at uscstaffclub@yahoo.com - No
exceptions!!

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