Current Graduate Student Scholarship Application

Personal Information

Full Name: *

NYU-Poly ID: *

Poly.edu Email Address: *

Preferred Phone Number: *

Background Information

I am: *

Academic Degree: *

Academic Program: *

Academic Load: *

Location: *

Planned Graduation: *

Estimated Cumulative GPA:

If unknown, leave blank

Planned Credit Load:

for Upcoming Semester

Application Data

I am applying for a: *

If applying for an upgrade, please specify your current scholarship:

Are you currently receiving or applying for additional aid outside of NYU-Poly?: *

E.g. scholarships, fellowships, grants, government sponsorship or any 3rd party funding source.

If so, please list all funding you will be receiving or applying for:

Please note that this information is for survey purposes only and will not be used to determine eligibility on funding.

Employment Information

Are you currently employed?: *

If yes:

Employer's Name:

Will your employer pay for graduate tuition?:

If yes, amount: $

Confirmation

I confirm all information in this application is true and complete to the best of my knowledge. I will promptly inform the scholarship coordinators of any changes in the information reported here. Failure to provide correct information will cancel my award eligibility. I am aware that my application information may be subject to independent verification by the Polytechnic Institute of New York University Scholarship Committee.

Full Name: *

Date: *

mm/dd/yyyy

Graduate School

Graduate School

Current Graduate Student Scholarship Application