BY DECEMBER 15, 2009, mail or bring all required materials (unofficial transcripts/DAR; letters of recommendation (optional)) to:
WiTEACH Program Office 127 Wyman Education Building UW-River Falls 410 S. 3rd Street River Falls, WI 54022
REQUIRED FIELDS ARE MARKED WITH AN ASTERISK *
*Last Name:
*First Name:
*Middle Name:
*Student ID/W number:
*Address: (include apartment or unit number)
*City:
*State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Select
*Zip:
*Phone:
*Email:
Providing the following demographic information is voluntary. This information will assist WiTEACH in evaluating student recruitment and retention policies. Scholarships are funded by donors and they often give these scholarships with the intent that they are awarded to students who meet very specific criteria. Please review the following criteria carefully and check any item that applies to you:
Male Female
American Indian or Alaskan Native
Black or African American
Native Hawaiian or Other Pacific Islander
Asian
Hispanic or Latino
White
Are you a new student (never attended UW-River Falls)? Yes No
Are you planning on enrolling full-time (12 or more credits per semester)? Yes No
If not planning on enrolling full-time, how many credits do you plan to take each semester?
How many total credits will you have at the start of fall term?
How many of your total credits are transfer credits?
Program of Study at UWRF:
Expected date of UWRF graduation:
Have you been accepted into the Teacher Education program? Yes No
Name of High School: Year of Graduation:
All previous colleges attended:
A 500-word essay explaining the reasons for choosing your particular field of study, your career goals, your plans for future study, and an explanation of why you should be selected in to the WiTEACH Leadership Program (essay guidelines). Write your essay in a word processing program and then copy and paste it below.
By clicking the submit button below you certifiy the following:
University of Wisconsin–River Falls 410 S. Third Street, River Falls WI 54022-5001 USA (715) 425-3911 Copyright © 1995-2009 University of Wisconsin-River Falls