Scholarship Student Survey

Name*

First Last

Class Year*

Major(s)*

Hometown State / Province / Region ZIP / Postal Code

Northland Email*

Personal Email*

Cell Phone*

College Activities

Please list organizations, awards, study abroad, athletics, etc. that you are involved.

Community Activities

Please list volunteer work, employment, etc.

Musical/Visual Arts Activities

Hobbies

Post-Graduation Plans

By clicking SUBMIT below, you authorize Northland College to disclose this information to donors who have funded your scholarship(s) and award(s). Contact information will not be shared with the donor.

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