2008-2009 Thomas Lord Scholarship Application

FOR STUDENTS ENROLLED OR PLANNING TO ENROLL AT PENN STATE ERIE, THE BEHREND COLLEGE

Consideration for this scholarship shall be given to full-time students enrolled or planning to enroll at Penn State Erie, The Behrend College, who have achieved superior academic records or who manifest promise of academic success and who have declared a major in the School of Engineering and Engineering Technology or the School of Science.  Consideration is also given to students in other majors at Penn State Behrend.  First preference will be given to children of employees of Lord Corporation.

DO NOT COMPLETE THIS APPLICATION UNLESS YOU HAVE A PARENT EMPLOYED BY LORD CORPORATION.

First Name:  Mid Init: 

Last Name:   

PSU ID: 

Email:

Home/Permanent Address 1 :

Home/Permanent Address 2:

City:   State:   Zip:

Current or intended major:

Name of Family Member Employed by Lord Corporation: 

Relationship to Student:

RELEASE STATEMENT:

In accordance with the Family Rights and Privacy Act of 1974, I hereby authorize the Financial Aid Office at Penn State Behrend to release the information contained on this application, in addition to grade point average, to representatives of the organization sponsoring the scholarship and members of the scholarship committee for use in evaluating scholarship applicants.

I understand that scholarship awards may be adjusted or revoked due to unsatisfactory academic progress, change in enrollment status, ceased enrollment at Penn State Behrend, or otherwise failing to meet the guidelines of the awarded scholarship.

SUBMIT THIS APPLICATION BY FEBRUARY 1, 2008.

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