NY State Scholarship

Personal Information

Name*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Country

Email*

Phone*

Semester you intend to start*

Class*

Scholarship Information

Are you a New York State resident?*

Did you graduate from a SUNY, CUNY, or NY State Community College?*

Was your cumulative undergraduate GPA a 3.0 or higher? Please have your official transcript sent directly to Xavier for verification.*

If yes, what was your cumulative undergraduate GPA?*

What school did you receive your undergraduate degree from?*

Please list the NY school(s) from which you graduated, the degree awarded, and your month and year of graduation:*

Acknowledgment

I have read and acknowledge the scholarship terms above and understand that a scholarship is not guaranteed to be given to me and may be revoked if terms are not met.

Signature*

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