North Texas GPA Scholarship Application

Section A: Application Brief

Name of Applicant*

City*

State*

Zip Code*

Phone Number*

E-Mail Address*

Name of University Applicant will be Attending*

Address of University Applicant will be Attending*

Applicant's University ID Number*

Academic Status for the Upcoming School Year*
First YearSecond YearThird YearFourth YearGraduate

Applicant's Cumulative GPA*

Applicant's Major GPA*

Degree to be Earned*

Expected Graduation Date (MM/YYYY)*

List Past and Present Engineering and Technology Classes Related to the Oil & Gas Industry*

Section B: Honors, Community, Work

Please list significant honors, scholarships, and awards received during your college years, in order of importance to you. If you have more than four, list the four most important only. Please include the name of the honor/scholarship/award, sponsor, basis for the award, and the date received.*

Please list school or community organizations and activities you have been involved in during your college years, in order of importance to you. If you have more than four, list the four most important only. Please include the name of the club/activity, position held, whether or not it was an elected position, and dates of involvement (MM/YY - MM/YY).*

Please list recent jobs, volunteer positions, or internships you have held. You may attach a resume in lieu of the information below. Please include the name of the company/organization, position held, dates of involvement (MM/YY - MM/YY), and average hours per week worked.

Upload Resume (PDF, DOC, DOCX only, max 5MB)

Section C: Scholarship Grant

Briefly explain your education, career interests, and goals. Include a description of any connection you currently have with the gas processing or midstream industry.*

I consent to allowing GPA Midstream North Texas to contact me and process my information.