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Center for Student Diversity

Community Enrichment and Enhancement Partnership (CEEP) Award Application

PLEASE NOTE: The personal information requested will be used to determine your eligibility for the CEEP Award. All fields marked with an asterisk are optional. Excluded information may affect the ability of the Center for Student Diversity (CSD) to determine your eligibility for the CEEP award, and/or to contact or notify you of your eligibility. You have the right to inspect, amend and/or correct all information on this form by contacting the CSD in person or in writing. The information on this form is not available for public inspection, and will not be shared with anyone outside CSD, with the exception of the University’s Office of Financial Aid.

For questions, please e-mail rwoodus@towson.edu.

A. STUDENT STATUS

Please mark your status


B. PERSONAL INFORMATION


 
4. Gender*

5. Martial status*



10. Where will you reside during the coming academic year?*

11. Race/Ethnicity*





12. Citizenship*



13. Did your parents graduate from college?*
If yes, what institution?

14. Do you reside in a single parent household?*

C. STUDENT DATA

2. FOR INCOMING FRESHMEN ONLY

3. FOR INCOMING TRANSFERS ONLY


  
4. FOR CONTINUING STUDENTS ONLY

Classification:

Enrollment Status:

Year in School:

Are you a degree seeking student?

D. EMPLOYMENT

1. Are you currently employed?

2. Do you plan to work during the academic term you are seeking the CEEP Award?

3. Where do you plan to work?

E. FINANCIAL AID

1. What financial assistance (grants, scholarships, loans, etc.) do you expect to receive in the coming academic year?

F. COMMUNITY INVOLVEMENT

1. In what campus activities/organizations have you participated during this year?

2. In which of these organizations/activities have you held leadership positions? Please describe your duties.

G. PLANNED CEEP INVOLVEMENT

1. What activities will you select to enhance your multiracial, multicultural knowledge?

2. Name university sponsored organizations you want to join to fulfill the CEEP Award requirement.

H. ADDITIONAL INFORMATION

1. Are there factors in your social and/or academic backgrounds that could have interfered with your educational goals?
If yes, please explain fully.

2. Did you overcome personal, social and/or physical obstacles in order to pursue your education?

If yes, please explain fully.

3. What other information do you want to mention or highlight as your application is considered for the CEEP Award?

I. CERTIFICATION

I certify that the information I have submitted on this application is accurate, true, and complete.

 

 


 

 

 

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