Financial Aid Supplement

Financial Aid Supplement Form

*Required Fields

1. If you are matched to one of our restricted funds, will you be willing to write a short note to the donor(s) of the fund? *    Yes   No

Personal Information

1. Legal First Name *
   
   
   
2. Legal Last Name *
   
   
   
3. Legal Middle Name
   
   
   
4. Email address * (include full email address)
   
   
   
5. What year do you anticipate graduating from MHC?
   
   
   
6. What is your anticipated major? *
   Note: this is not an official declaration of your major nor is this an official list of majors.
   AFRAM - Afr. Amer.& African Studies AMST - American Studies ANTHR - Anthropology ARTH - Art History ARTST - Art Studio ASIAN - Asian Studies ASTR - Astronomy BIOCH - Biochemistry BIOL - Biological Sciences CHEM - Chemistry CLASS - Classics COMOR - Complex Organizations COMSC - Computer Science CST - Critical Social Thought DANCE - Dance ECON - Economics EDUC - Education ENGL - English ENVST - Environmental Studies EURST - European Studies FLMST - Film Studies FREN - French FRTRL - First-Year Tutorials GEOG - Geography GEOL - Geology GREEK - Greek GRMST - German Studies HIST - History INDPT - Interdepartmental IR - International Relations ITAL - Italian JWST - Jewish Studies LATAM - Latin American Studies LATIN - Latin MATH - Mathematics MEDST - Medieval Studies MUSIC - Music NEURO - Neuroscience & Behavior PE - Physical Educ. & Athletics PHIL - Philosophy PHYED - Physical Educ. & Athletics PHYS - Physics POLIT - Politics PSYCH - Psychology RELIG - Religion RES - Russian & Eurasian Studies ROMLG - Romance Lang. & Literature SPEC - Special Major SOCI - Sociology SPAN - Spanish STAT - Statistics THEAT - Theatre Arts WOMST - Women's Studies Undecided
   
   
7. What is your anticipated minor? *
   Note: this is not an official declaration of your minor nor is this an official list of minors.
   AFRAM - Afr. Amer.& African Studies AMST - American Studies ANTHR - Anthropology AFRST - African Studies ANCST - Ancient Studies ARTH - Art History ASIAN - Asian Studies ASTR - Astronomy BIOL - Biological Sciences CHEM - Chemistry CLASS - Classics COMOR - Complex Organizations COMSC - Computer Science CST - Critical Social Thought DANCE - Dance ECON - Economics EDUC - Education ENGL - English ENVST - Environmental Studies EURST - European Studies FLMST - Film Studies FREN - French GEOG - Geography GEOL - Geology GREEK - Greek GRMST - German Studies HIST - History ITAL - Italian JWST - Jewish Studies LATAM - Latin American Studies MATH - Mathematics MEDST - Medieval Studies MUSIC - Music PHIL - Philosophy PHYED - Physical Educ. & Athletics PSYCH - Psychology POLIT - Politics RELIG - Religion RES - Russian & Eurasian Studies RESL - Russian Language & Literature SOCI - Sociology SPAN - Spanish SPEC - Special Minor STAT - Statistics THEAT - Theatre Arts WOMST - Women's Studies No Minor
   
   
8. Permanent home address
   
   Street * 
   
   City * 
   
   State * No State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC 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
   
   Zip code *
   
   Country * 
   
   
9. Do you have a handicap/disability?     Yes   No
   
   If yes, please describe
   
   
10. Are you intending to attend graduate school?    Yes   No
    
    If yes, what field/major (do not abbreviate)?
    
    
    
11. Are you planning a career as (check all that apply)
    
      Doctor
    
      Nurse
    
      Other Medicine - If yes, please describe: 
     
    
      Social Worker
    
      Missionary Work in the US
    
      Missionary Work Abroad
    
      Teaching - If yes, what do you plan to teach?
    

Education Information

1. What High School did you attend? Please spell out all names, do not use abbreviations, i.e.: Holyoke H.S. should be spelled out Holyoke High School.
   
   Name
   
   City
   
   State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC 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
   
   Country
   
   
2. Which of the following best describes the type of high school you attended (check one answer)
   
     Public
   
     Independent, not religious affiliated
   
     Independent, Catholic
   
     Other Independent, religiously affiliated
   
   
3. Are you a transfer student?    Yes   No
   
   If yes, what school did you transfer from? Please spell out all names, do not abbreviate.
   
   Name
   
   City
   
   State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC 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
   
   Country
   
   

Family History

1. What is your country of citizenship?
   
   
   
2. Place of Birth
   
   City
   
   State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Washington DC 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
   
   Zip code
   
   Country
   
   If you are an American Citizen, do you consider yourself to be
   American Indian or Alaskan Native Asian, Asian American, or Pacific Islander Mexican American or Chicano Puerto Rican Latin American, South American, Central American, or other Hispanic Black or African American White Other
   
   
3. Would you claim to be of (please answer yes or no for each category)
   
   
   • New England lineage?    Yes   No
     
   • Armenian descent?   Yes    No
     
     
   • Asian descent?    Yes   No
     
     
4. What is your preferred religious affiliation?
   No Religion Bahai Buddhist Catholic Hindu Jewish Muslim Protestant Unitarian Universalist Pagan/Wiccan Other Religion
   
   
5. Are either of your parents teachers in a high school, junior high, middle school or elementary school?
     Yes   No
   
   
6. Are either of your parents members of the clergy?    Yes   No
   
   
7. Are either of your parents officers in the Army?    Yes   No
   
   
8. Are 2 or more of your family members attending an institute of higher education?   Yes   No
   
   
9. What is the highest level of education your mother completed through graduation?
   Dropped out before completing High School Received GED High School 2 year college 4 year college graduate degree
   
   
10. What is the highest level of education your father completed through graduation?
    Dropped out before completing High School Received GED High School 2 year college 4 year college graduate degree
    
    
11. Were any of your parents or grandparents missionaries? (please answer yes or no for each category)
    
    • Parent,  Yes    No
      
      
    • Grandparent,  Yes   No
      
      
12. Do you have any relatives who have attended/are attending Mount Holyoke?   Yes   No
    
    If yes, who
    
    

Tell Us More About You

1. Have you participated in the junior year abroad program?   Yes   No
   
   
2. If so, please provide information on the country, university or college attended, and area of study.
   
   Country
   
   City
   
   University or College
   
   Area of Study
   
   If you have not participated, do you plan to in the future?   Yes   No
   
   Year of participation or anticipated participation
   
   
   
3. Have you received any academic awards/recognition?    Yes   No
   
   If yes, please list:
   
   
   
4. Have you/do you belong to any campus/student organizations/clubs/MHC sports teams?    Yes   No
   
   If so, please list and note any offices held i.e., Treasurer, Editor, etc. AND the year of membership (i.e. sophomore year).
   
   
   • Name of Organization
     
     Position Held
     
     Years of membership:   First-Year   Second-Year   Junior   Senior
     
     
   • Name of Organization
     
     Position Held
     
     Years of membership:   First-Year   Second-Year   Junior   Senior
     
     
   • Name of Organization
     
     Position Held
     
     Years of membership:   First-Year   Second-Year   Junior   Senior
     
     
   • Name of Organization
     
     Position Held
     
     Years of membership:   First-Year   Second-Year   Junior   Senior
     
     
   • Name of Organization
     
     Position Held
     
     Years of membership:   First-Year   Second-Year   Junior   Senior
     
     
5. If you have participated in any internships/on-campus jobs/volunteer activities, please detail below:
   
   
   • Name of Organization
     
     Position & Activities
     
     Years of membership:   First-Year   Second-Year   Junior   Senior  
     
     
   • Name of Organization
     
     Position & Activities
     
     Years of membership:   First-Year   Second-Year   Junior   Senior  
     
     
   • Name of Organization
     
     Position & Activities
     
     Years of membership:   First-Year   Second-Year   Junior   Senior  
     
     
   • Name of Organization
     
     Position & Activities
     
     Years of membership:   First-Year   Second-Year   Junior   Senior  
     
     
   • Name of Organization
     
     Position & Activities
     
     Years of membership:   First-Year   Second-Year   Junior   Senior
     
     
6. What are your plans for the upcoming summer?
   
   
   
7. What are your post-graduation plans i.e. work, travel, internship, graduate school?