JOY ANDERSON SCHOLARSHIP APPLICATION EASTERN KENTUCKY UNIVERSITY DEPARTMENT OF OCCUPATIONAL SCIENCE AND OCCUPATIONAL THERAPY APPLICANT INFORMATION Name: EKU Student ID Number: Local Phone: Local address: City: State: ZIP Code: State: ZIP Code: Permanent address: City: E-mail: Other Phone: Applicant Signature: Date of Application: SCHOLARHIP CRITERIA Criteria: Enrolled in year of the Master of Science in Occupational Therapy Program Min GPA of 3.00 Resume demonstrating potential as an occupational therapist 1-2 page, typed and double-spaced, essay addressing professional goals and potential as an Occupational Therapist Completed Student Aid Report (SAR) (summary of rated FAFSA) demonstrating financial need SUBMIT ALL COMPLETED APPLICATION MATERIALS TO PEGGY BOWMAN IN DIZNEY 103 BY THE DEADLINE DATE FOR OFFICE USE ONLY Application Form Complete: YES Essay Attached: Resume Attached: YES YES NO NO NO Date Received: GPA: