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2015 Gateway Badgers’ Scholarship Application
Application Deadline is April 18, 2015
The St. Louis Chapter of the University of Wisconsin Alumni Association is offering both merit-based and need-based
scholarships for current high school seniors who are pursuing a degree at the University of Wisconsin-Madison. The
amount of the scholarship is a minimum of $500, and up to $2000, towards the first semester tuition of the freshman year.
Fundraising profits determine the actual dollar amount available for distribution among each year’s worthy and best
applicants. Scholarship awards will be paid directly to the UW-Madison and applied toward tuition for the first semester of
the freshman year.
Scholarship Criteria:
1. A resident and graduating senior at a local metropolitan St. Louis area high school (including southwestern
Illinois)
2. Accepted and committed to enroll at the University of Wisconsin-Madison
3. Demonstrate scholarship achievement by having an unweighted GPA of 3.25 or better (out of 4.0)
4. Demonstrate scholarship achievement by having an ACT score of 27 or better/SAT score (combined) of 1800
or better
5. Demonstrate extracurricular involvement in school and/or community
6. Demonstrate strong character, and will be a good representative of UW-Madison
7. Exhibits potential for achievement after graduation
8. For need-based scholarship, demonstrate unmet financial need
To apply, please provide the following items:
 Enclosed application (please type);
 Enclosed FERPA release form, signed by hand and dated;
 1 letter of recommendation from your high school faculty, counselor, or other non-family person who can attest to
your academic abilities and personal qualities;
 Official high school transcript;
 Copy of ACT/SAT scores;
Send all materials to Kim Stewart (Scholarship Chair):
1. Email electronic documents to jgalens@aol.com; &/OR
2. Mail paper documents to Kim Stewart, 2117 Brook Hill Ridge Dr., Chesterfield, MO 63017-7959.
Applications are treated as highly confidential among members of the scholarship selection committee.
Materials must be received no later than April 18, 2015. For questions, contact Kim Stewart, Gateway Badgers’ Scholarship
Chair, at jgalens@aol.com, or (636) 391-8807.
To be completed online by Scholarship Applicant (boxes will expand to accommodate any length of answer):
Name:
High School:
Date of Birth:
High School unweighted GPA:
Home Address:
Home Phone:
Cell Phone:
Email:
Parents’ or Guardians’ Names:
High School weighted GPA (if you have one):
SAT Scores Math:
Critical Reading:
Writing:
ACT Scores:
Have you committed to UW-Madison?
UW Student ID:
Campus Address (if known):
Number of family members, at home and in college, who
will be supported by parents, guardians:
Number of immediate family members who will be in
college this fall, including you:
Anticipated Major (if known):
Name of local newspaper:
Describe your high school academic honors, scholarly activities, research:
Describe your high school academic extracurricular activities (e.g. athletics, music, student government):
Describe your non-academic extracurricular activities in the community outside of school (e.g. religious, political, scouting,
hospital volunteering):
List your work experience: (begin with the most recent employment), including type of work, employer, dates of
employment, and hours per week worked:
Describe how you spend your summer vacations, and how you plan to spend the one before starting at UW- Madison:
Describe what St. Louis means to you:
Why have you chosen the University of Wisconsin – Madison for your college education?
Describe your goals at UW. What do you hope to accomplish? What do you plan to do with your degree after graduation?
What have you done that indicates your strength of character, and foretells that you will become a good representative of
the University of Wisconsin?
Why would a scholarship from the Gateway Badgers be important to you?
How do you plan to finance your college education? (Indicate % from work, savings, scholarships, parents, etc.)
For what other scholarships have you applied?
To be considered for one of the needs-based scholarships, please describe that financial need in enough detail to justify an
award to you. Include any extenuating circumstances of which we should be aware.
Will you be participating in athletics, and if so, what? (We will need to check with UW Compliance to make sure an award
from us will not affect your status, or other financial aid awards.)
Is there anything else we should know about you that would be of importance to the committee in its decision to award
you a scholarship?
Please list name, address, and phone number of the high school administrator for graduating seniors:
TO: Wisconsin Alumni Association Scholarship Applicant
FROM: Wisconsin Alumni Association
Family Educational Rights & Privacy Act (FERPA) Release
The scholarship award for which you are applying may contain funds donated to local chapters, WAA, UWMadison or the UW Foundation. At times, local chapters may need information regarding applicants that may
include financial need, class rank, test scores and grade point average. In order to release this information, we
need your consent. If you check the “Yes” box below, you are giving your consent to release this information for
the duration of your attendance at UW-Madison.
By checking the “Yes” box below, I agree to the release of information as described above.

Yes, I agree to release of information.

No, I do not agree.
Student Signature _______________________________________ Date ____________________
Campus ID#__________________________________________
Net ID# _____________________________________________
Date of Birth _________________________________________