Application for Institutional Graduate Financial Assistance

Old Dominion University Norfolk, VA 23529

This form is to be submitted to your graduate program director (or to the administrator of a campus unit that may offer an assistant- ship). To maintain eligibility for financial assistance, you must remain enrolled in graduate course work for the required number of credit hours as specified for each form of assistance. Students interested in applying for federal assistance must complete the Free Application for Federal Student Aid (FAFSA). Name Last Address Citizen of Telephone Daytime Program of Study Degree Sought Highest Degree Held, Including Major Evening Social Security Number Date of Birth First Middle

Type of Support Requested (See special deadline dates on departmental admission requirements sheets.) Doctoral Fellowship
Part-Time Tuition Grant

Research Assistantship Teaching Assistantship*

Tuition Grant University Fellowship

* International students applying for these awards must present scores on oral English proficiency and written English examinations.

Period for which support is being requested (If past deadline, application will be processed for the next academic year or semester, whichever is appropiate and funds permitting.) year term Date on which you submitted your application to the Office of Admissions (Do not submit this financial assistance application before you have applied for admission to a graduate degree program at Old Dominion University. Only regularly or provisionally admitted students are eligible to receive financial assistance of any type.) Domicile Office Classification (in-state or out-of-state tuition rate) Graduate Test Scores (if required by your program) GRE: Verbal GMAT TOEFL Quantitative SPEAK Analytical MAT PRAXIS Advanced MCAT

Goals and Interests Statement Please submit with this application, on a separate attached page, a brief essay in which you discuss your career goals and interests. IMPORTANT: All award recipients must be degree-seeking graduate students in good standing. Please refer to the University Catalog for further information on policies governing graduate financial assistance.

I certify that all information provided above is accurate to the best of my knowledge.

Applicant's Signature

Date

Applications for graduate financial assistance will be accepted beginning with the spring semester (for consideration for assistance in the following academic year). Consult the Departmental Requirements section of this application for department deadlines. Students interested in federal financial assistance apply by submitting the FAFSA by Feb. 15 for the following fall. The Office of Financial Aid is located in 126 Alfred B. Rollins Jr. Hall, (757) 683-3683. (The FAFSA is available at any college financial aid office or online at www.fafsa.ed.gov.) Old Dominion University is an affirmative action, equal opportunity institution and does not discriminate in admissions, employment, or any other activity on the basis of race, sex, color, age, religion, national origin, disability or veteran status.