CSI Multicultural Day


Multicultural Day Scholarship Application

First Name:
Middle Initial:
Last Name:
CSI ID Number
Birth Date:
Home Phone:
Cell Phone:
(eg. 111-111-1111)
State:    Zip Code:
High School:
High School Graduation Year:
Current Cumulative G.P.A.:
Intended Field of Study:

List all community and school involvement: leadership, honors, awards, organizations.
What are your educational and career goals and how do you intend to achieve them?
By submitting this form, I hereby affirm that ALL information provided in this application and/or submitted in support of this application is true and accurate. I understand that providing false or misleading information may result in denial of the application and/or disciplinary action.

I confirm that I meet ALL the eligibility requirements listed for this scholarship.

I hereby authorize the College of Southern Idaho to release information contained in or submitted in support of this application and in my education records (such as major, transcript, GPA, number of credits enrolled in/completed, academic standing, and other similar information) to scholarship donors, members of the Scholarship Selection Committee, and other appropriate parties in connection with the scholarship I am applying for.