Office of Admission • One Morgan Place • Yellow Springs, OH 45387 • 937.319.6082 • [email protected] • www.antiochcollege.org
HORACE MANN SCHOLARSHIP NOMINATION FORM
TO THE applicant
This nomination form must be submitted by January 15 as your
application to the Horace Mann Scholarship. You may be
nominated by Antioch College alumni, faculty, staff or a member
of the broader Antioch College community. A teacher or school
official may also submit this nomination on your behalf. More
information is available at www.antiochcollege.org/finaid.
Legal name, exactly as it appears on official documents:
Last/family/sur name first/givenmiddle (complete)
Suffix:
Jr.
Sr.
birth date (mm/dd/yyyy)
II
III
Social Security Number (optional)
In honor of Antioch College’s first president, this prestigious, full-tuition
award is granted to the very best students who demonstrate a high level
of curiosity and sense of purpose in the work that they do, both in the
classroom and in their communities.
This is a highly competitive scholarship and the awarding process is based
on a combination of factors, from academic credentials and personal
achievements, to information shared in the nomination form, scholarship
essay and personal interview.
Horace Mann Scholarship application checklist:
Application for Admission: You must apply by the January 1
Early Action deadline.
Nomination Form
Scholarship Essay: See information below
Personal Interview: Required for all Horace Mann Scholarship
applicants. Information on requesting an interview is available
at www.antiochcollege.org/finaid.
Scholarship nomination form and scholarship essay must
be mailed or faxed to:
permanent home address:
number and street apartment #
City/town
The Horace Mann Scholarship (Full-tuition)
State/province
zip
Antioch College
Office of Admission & Financial Aid
One Morgan Place
Yellow Springs, OH 45387Fax: 937.319.6085
scholarship essay
Please submit an essay of approximately 500 words on the following topic: Inquiry, Work, Community.
Antioch relationships
Nominator
Please list any relatives who have attended Antioch College, including
year(s) of graduation or date(s) attended.
Name
Relationship
to you
Graduation
date or dates
attended
Please describe any other connection that you may have with the
Antioch College community.
Nominator’s Name (Mr./Ms./Dr., etc.)
Suffix:
Jr.
Sr.
II
III
Is your nominator an Antioch College:
Alumnus/a
Faculty
Staff
Member of the broader Antioch College community
Other
If other, please specify:
Horace Mann Scholarship Nomination Form
To the nominator
Thank you for nominating this student for an Antioch College full-tuition scholarship. As part of our mission to provide greater access to a high
quality liberal arts education, Antioch College is committing significant financial resources to enroll a diverse group of intellectually inquisitive
students who are open to new experiences. Please describe in a few sentences why you feel this student is a good match for Antioch College
and an ideal candidate for this prestigious award. You may attach a separate sheet if necessary.
Check here if you are a teacher or school official and feel this is already reflected in a letter of recommendation you are writing on behalf of
the student. You may include additional comments in the space below.
Nominator Name
Antioch College affiliation (if any)
Address
TelephoneEmail
I RECOMMEND THIS STUDENT:
No basis
With reservation
Fairly strongly
Strongly
Enthusiastically
SignatureDate
Antioch College • Office of Admission • One Morgan Place • Yellow Springs, OH 45387 • 937.319.6082 • fax 937.319.6085 • antiochcollege.org
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