Staff Council (UUSC) Scholarship Application Form

Explanation of Awards Granting Process

Applicants:

Thank you for your interest in the Staff Scholarship Award. The University of Utah Staff Council (UUSC) is pleased that we are able to offer this award to the University's outstanding staff. Four awards of up to $500 will be made per year, with two awards in the Fall Semester and two awards in the Spring Semester. Recipients must meet the criteria listed below and must be register for the class, symposium, conference or workshop they wish to participate in. The Staff Scholarship Awards Committee will process the awards based on the location of the educational opportunity. For on-campus educational offerings, the cost of the course tuition (up to $500) will be credited to the employee’s tuition bill. For all off-campus offerings, the committee will require either an invoice from the educational provider or an original receipt of tuition payment for reimbursement (up to $500). The committee will process the scholarship in the most fair and judicious manner to benefit the employee, according to the procedures directed by University of Utah policy. UUSC is an equal opportunity provider.

To be considered, each University staff applicant must meet the following criteria:

  • Currently working in a 75% FTE (30 hours per week) or greater position.
  • Has worked for the University in a 75% FTE or greater benefited position for the past consecutive two years.
  • May apply one time per academic year –please see deadlines posted each semester. Individuals may receive a scholarship once per academic year, in fairness to all who may submit their applications.
  • Current Staff Council members are not eligible.
  • Incomplete applications will not be accepted and considered void.

AUTUMN 2009 APPLICATION DUE BY: August 14, 2009 by 2:00 PM

Provide the following information about yourself (the applicant).

Applicant's Name:

Campus Phone:    7-digit phone number only, no area code needed.

Campus Department:

Campus Address:
Please submit the CAMPUS address, rather than a U.S. Postal Service mailing address (unless applicant/nominee is located off-campus). Example: “150 PARK” (room number + building designation) instead of “201 S. President's Circle, Rm 150”

E-Mail Address:   

Supervisor's Name:

Supervisor's Campus Phone:     7-digit phone number only, no area code needed.

Current Position:

University Hire Date (mm/dd/yy format):

Length of employment in current position (in years):    Years:       Months:

If less than one year in current job, list other positions held:

Course Name and Brief Description:

Organization/Institution Offering Course:

Tuition Fee ($):

Tuition Due Date (mm/dd/yy format):

Book/Special Fees ($):

Please provide below a statement with your explanation of how this scholarship will benefit you and the University of Utah. If this field is left blank, then your application will be disqualified from consideration.

Statement (maximum 750 characters including spaces):

Thank you for your time and effort in making making your application clear and precise. Unfortunately, any applications received that cannot be understood by the committee members will deleted from the pool of applicants.

For questions or problems using this form, contact Edwin V. Lyons at e-mail edwin.lyons@utah.edu  or phone 581-8365.

Last updated July 28, 2009.

Before submitting the form, please re-read your entries to be certain they are complete and correct.

The applicant will receive an e-mail reply to confirm that the Scholarship Committee has received the application.

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