Diversity Retention Scholarship Application 2012-2013

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Mailing Address:
The Office of Diversity and Community Engagement,
The University of Texas at Dallas,
800 W. Campbell Road, AD26,
Richardson, TX 75080

Physical Location:
Administration Building AD 3.207
Phone: (972) 883-4566
Fax: (972) 883-4565


News and Events

                   Last Name                  Middle Init.         First Name

Name*:   

Address*:

                

Phone*:   

Email*:    

Prefer to be notified by Email: Yes   No

How did you find out about this scholarship?:

Have you been awarded Financial Aid for 2012-2013?: Yes   No

If YES, what is the amount of your unmet need?:$

List any additional scholarship awards you are receiving below (include the award amount)*:

Do you have dependents?:    Yes   No

If Yes, how many dependents?:             

Cumulative GPA on college coursework*:

Major (Intended Field of Study):            

Minor (Intended Field of Study):            

Please list your campus leadership and community service activities :

Please type one- to two-page, double spaced essay on the following topic: How will the Diversity Retention Scholarship assist me in obtaining my college degree? (Describe any special challenges or circumstances that will prevent you from completing your degree)*:

Demographic Information (optional) - This information will be used for statistical purposes only.

Gender:    Male   Female

Ethnicity: 

White   Black, Non Hispanic   Hispanic  

Asian/Pacific Islander    Native American   

Other      (If Other, Please Specify)

Please bring to the University of Texas at Dallas Multicultural Center (located in SSB 2.400):

  • Copy of an unofficial UT Dallas transcript
  • (Optional) A copy of your UT Dallas Financial Aid Award notice (note: must show unmet need)