MARY WITT SCHOLARSHIP FUND

Individual Application

Name_____________________________________________________________________________________

Address___________________________________________________________________________________

City, State, Zip Code________________________________________________________________________

Home Telephone (_____)____________Cell Phone (_____)____________Work Phone (_____)____________

Place of Employment________________________________________________________________________

Address of Employment______________________________________________________________________

Position Held_______________________________________________________________________________

Primary ethnic group with which you identify_____________________________________________________

Age_________________ Gender________________

Name of Travel Seminar______________________________________________________________________

Dates of Travel Seminar______________________________________________________________________

Amount of Scholarship Funds requesting_________________________________________________________

Religion (optional)___________________________Name of Home Congregation________________________

I. Biographical Information (Family, education, hometown, special interests, etc.)

II. Indicate organizations of which you are a member, boards on which you serve, committees of which you are a member, community involvement (particularly grassroots).

III. What are your expectations from this travel seminar?

IV. What plans do you have for sharing your learning and experiences from this travel seminar?

V. Name and telephone of professor sponsoring this travel seminar (if applicable). We may contact the sponsor as a reference for your application.

Name: ____________________________________________ Telephone: (_____)_____________________________

VI. FINANCES AND PERSONAL RESOURCES

A. Mark your approximate annual salary, family status and number of dependents.

(NOTE: include spouse income if you are married.)

Check one: Family status:

_____ 0 - $10,000 _____ single

_____ $10,000 - $20,000 _____ married

_____ $20,000 - $30,000

_____ $30,000 - $40,000

_____ $40,000 - + Number of dependents________

B. (For students only):

Are you eligible for financial aid? YES NO Are you receiving financial aid? YES NO

How much financial aid will be applied toward this program? _______________________

Signature of certified financial aid director from your school:

Signature _______________________________________Date ____________________________________

Title __________________________________________ Contact Phone Number (_____)_______________

C. Please reread the scholarship program policy, noting in particular the purpose of the program, which states for whom it has been established. Then indicate below the factors that make you an appropriate recipient of scholarship funds (please attach a separate sheet if necessary).

D. Total cost of the travel seminar__________________________________________________

E. Amount of the total cost that you expect to raise_____________________________________

F. Please indicate additional sources of funding or resources that you expect to attain for this travel seminar.

G. Please list your international travel experience from the last five years, and include any international travel plans you have six months after the date that this travel seminar ends.

VII. Is there any other information you would want us to know prior to making our decision?

Signature______________________________________________ Date____________________

Please return this application to the Center for Global Education, Augsburg College, 2211 Riverside Avenue, Minneapolis, MN 55454. If questions, call 612-330-1159.

MARY WITT SCHOLARSHIP FUND

PROGRAM POLICY

Purpose of the Fund

The Mary Witt Scholarship Fund was established in 1987 in memory of Mary Witt, who was killed in a car accident several months after participating in a Center for Global Education travel seminar to Central America. The Center attached the fund to Mary's name because of her inspiring commitment to a more inclusive, just and peaceful world. The money in this small fund enhances opportunities for persons lacking sufficient personal resources, especially persons of color, to participate in Center for Global Education travel seminars and meet their counterparts in other countries who are working for social change. The primary focus of the fund will be travel groups; however, consideration will be given to individuals who meet the general and specific criteria listed below.

FINAL DECISION REGARDING THE AWARDING OF FUNDS RESTS WITH THE CENTER FOR GLOBAL EDUCATION.

GENERAL CRITERIA: Individuals and groups seeking scholarship funds under this program:

1. Should apply at least four months prior to the expected date of departure.

2. Will be expected to contribute a portion of the total cost of the trip.

3. Should be able and willing to share their experiences with community organizations/ groups, schools, churches, elected officials/bodies, etc.

4. Should be willing to participate in pre-trip study and/or orientation and to provide an account of the travel experience, e.g. individual or group journals (summary), photos/slides, tapes, etc., which may be used at the discretion of the Center for Global Education.

SPECIFIC CRITERIA:

Travel/Study Groups seeking funds from this program:

1a. Should ensure that the group includes broad representation of the peoples for whom the scholarship fund is intended.

b. Should include at least four persons of color.

2. Will be encouraged to explore other financial resources, internal as well as external, prior to seeking Center for Global Education scholarship funds.

4. Will be expected to return scholarship money if they raise funds sufficient enough to assume the total costs of the trip.

5. Will be given preference for funding if they pool their resources (i.e. have a shared travel financial "kitty" vs. individual payments).

6. May apply for funds for an individual participant who meets the general criteria and who meets the criteria for individual applicants.

MAXIMUM GRANT PER GROUP WILL NOT EXCEED 20% OF TOTAL COST FOR ALL PARTICIPANTS, ACCORDING TO THE RESOURCES AVAILABLE TO THE CENTER FOR GLOBAL EDUCATION.

Individuals seeking funds from this program:

1. Should meet the general criteria and be a member of one of the groups listed under the purpose of the program.

2. Should be able to document financial need. Student status alone will not be sufficient documentation of financial need. Students may be requested to provide financial aid documents.

3. Might be asked to prepare a statement (written or taped) of how the travel/study experience will enhance their understanding of work with people of color and/or low-income populations.

4. Will be encouraged to explore other resources prior to seeking Center for Global Education funds.

THE AMOUNT OF THE SCHOLARSHIP PROVIDED WILL DEPEND ON THE APPLICANT'S NEED AND THE RESOURCES AVAILABLE TO THE CENTER FOR GLOBAL EDUCATION AND WILL RARELY EXCEED 50% OF THE TOTAL COST OF THE TRAVEL SEMINAR.

3/5/2005

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