Rush Scholarship Application

Before filling out this form, please read the eligibility criteria.

on a scale

out of

Please list any organizations in which you were involved in high school, along with the year(s) when you were involved. You may also list organizations that were not necessarily associated with your high school.

Please list any offices to which you were elected in high school, along with the year in which you served the office.

Please list any athletic involvement during high school. Include your highest level of involvement with your team (i.e. Varsity football team, starting wide receiver).

Please list any honors, scholarships, or awards you may have received during high school. Include academic, athletic, and extracurricular achievements.

Please list your work experience, including your employer, your title, the number of hours worked per week, and the duration of your employment.

Please list your hobbies and recreational activities.

Please provide the names of two references whom we may contact before awarding you this scholarship. (Name, phone number, relation)