Due: February 15th

To apply for an ACRES scholarship you must:

1. Fill out the following personal information fields
2. Write and submit an essay essay describing the advantages and disadvantages of rural special education, your needs for scholarship funds, how you plan to use the scholarship, what you will do to share the information gained with other educators
3. Submit two letters of recommendation

• For help with the content of this application form, please e-mail Lori Garnes: garnesl@minotstateu.edu.
  
• For technical help with this form or to report problems, please e-mail webmaster@acres-sped.org.

Personal Information
First Name:
Last Name:
E-mail:
Social Security Number:
Current Address Street: City: State: Choose one 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 ZIP: Phone: Permanent Address Street: City: State: Choose one 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 ZIP: Phone:
U.S. Citizen:	Yes   No
Ethnic Origin (optional):	Native American   Hispanic   Black   Asian/Pacific Islander   Caucasian   Other
Highest degree obtained:	Major:
Name of Institution:	Date:
List current certifications:
Current employer:
Position:
Previous related work experience:
Institution at which scholarship will be used:
Essay Scholarship applicants must write submit an essay describing the advantages and disadvantages of rural special education, your needs for scholarship funds, how you plan to use the scholarship, what you will do to share the information gained with other educators. You may choose to (1) type or paste your essay into the form field below, (2) upload your essay as an RTF file using the upload function below, or (3) mail your essay along with your two letters of recommendation (address listed below). Option 1. Type or paste in essay: Option 2. Upload essay (must be a RTF file): Option 3. Mail essay along with letters of recommendation (address listed below).
Letters of Recommendation Before your scholarship application will be considered you must submit two letters of recommendation (and your essay if not submitted electronically) in a single envelope to: Lori Garnes Minot State University 500 University Avenue West Minot, ND 58707 By submitting this application I certify that the information contained in this application and the statements attached are true and correct to the best of my knowledge. I authorize the release of my grade transcripts and the extent of my financial need to interested donors of scholarships who request this information. Because essay files must upload, submission may seem slow NOTE: If you do not receive a success message, or to report other problems, e-mail webmaster@acres-sped.org.