English Department Scholarships and Awards Student Information Page

Complete the form below by January 31, 2018, to be considered for awards made in spring 2018.

Name Name First Last
E-Number (but leave off the E)
Anticipated Semester of Graduation
Local Address Local Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Permanent Address Permanent Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Local Phone Local Phone - ### - ### ####
Permanent Phone Permanent Phone - ### - ### ####
EIU Email
Alternate Email
Total Semester Hours Completed as of End of Fall Semester
Transfer Hours
EIU Hours
EIU GPA
English GPA
Teacher Certification

Teacher Certification Yes No
Are you a non-major and wish to be considered only for the Mary Coon Cottingham Scholarship?

Are you a non-major and wish to be considered only for the Mary Coon Cottingham Scholarship? Yes No
1. Undergraduate academic honors/award
2. University activities
3. Employment record
4. Career objectives
5. Financial need (Explain, please.)
6. Former and current instructors who might offer recommendations/comments
7. Other relevant information