First Name *

Last Name *

G-Number *

Phone Number *

GVSU Email Address *
Please enter a GVSU student email address ending in @mail.gvsu.edu.

GVSU Email Address (Confirmation) *

Street Address *

City *

State *
- Select State Alabama Alaska American Samoa Arizona Arkansas Armed Forces Afr/Can/EU/ME Armed Forces Americas Armed Forces Pacific Baker Island California Colorado Connecticut Delaware Federated State of Micronesia Florida Georgia Guam Hawaii Howland Island Idaho Illinois Indiana Iowa Johnston Atoll Kansas Kentucky Kingman Reef Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Midway Islands Minnesota Mississippi Missouri Montana Navassa Island Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Palmyra Atoll Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Trust Territory of Pacific Utah Vermont Virgin Islands Virginia Wake Island Washington Washington D.C. West Virginia Wisconsin Wyoming

Zip Code *

GVSU Grade Point Average (GPA) *

Please select your desired placement location: *
- Select Option Detroit (only available for Internship) Greater Grand Rapids

Please select your clinical field experience level: *
- Select Option Teaching Apprenticeship Student Teaching Internship

Major: *

Please select your program: *
- Select Option Birth to Kindergarten Elementary Education Secondary Education Special Education

Please list your program Minor(s): *

In 300 words or less, please explain why you are interested in this specific scholarship opportunity. *
Please enter at most 300 words. You currently have:

• I understand that limited GVSU Charter Public Schools Clinical Field Experience Scholarships are available; completion of this application does not indicate receipt of a scholarship.
• I understand that financial need, determined by information submitted via the FASFA form, may be considered in determining scholarship recipients. 
• I understand that ccholarships will be awarded based on the availability of a placement and a mentor teacher meeting individual certification requirements.
• I understand that scholarships will be distributed as evenly across Program Levels as each semester's applicant pool allows.
• If selected to receive the scholarship, I understand that I will complete my Clinical Field Experience at a GVSU-authorized charter public school. 

I hereby confirm that I have thoroughly reviewed the provided information and completed this application truthfully and accurately.

Today's Date *
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