formerly University of Missouri-Rolla
WISE Transfer Scholarship

Name:


Home Address (street/city/state/zip):


Telephone number:


Email address:


Date of Birth:


Ethnicity
African American
Asian
Caucasian/White
Hispanic
Native American
Other


Are you a U.S. citizen?
Yes
No


Permanent Resident?
Yes
No


When do you plan to enroll at Missouri S&T (semester & year)?


Have you been accepted to Missouri S&T?
Yes
No


List all colleges or universities you have or are currently attending:


Number of hours passed:


Cumulative GPA:


Intended major:


Briefly describe below your academic achievements, including extracurricular activities, interests and any honors or recognition you received.


State briefly why you are interested in engineering or science.


Will you be receiving your associates degree?
Yes
No


If yes, by what date?