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Scholarship Form

Please read the scholarship frequently asked registration questions article before applying for a scholarship online. You can also download a paper copy of the scholarship form, fill it out by hand and mail it to our scholarship coordinator. If you have any questions about scholarships, please read our scholarship brochure or contact the scholarship coordinator.

Name & Contact Information

First Name (*)
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Last Name (*)
Please enter your last / family name
   
Address (*)
Please enter your address
   
City (*)
Please enter the name of your city, town, village or other location
   
State or Province (*)
Please select your state or province
   
ZIP or Postal Code (*)
Please enter your ZIP code or postal code
   
Country (*)
Please enter your country
   
Primary Telephone
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Other Telephone
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Email Address For Emails From Cymdeithas Madog
   
I Prefer To Be Contacted By: (*)
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School / Work Information

Age As Of July 16, 2017
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For applicants for the Mergenthal Scholarship
   
Are You Currently A Student
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School Name And Address
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Full Time Or Part Time Student
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Field Of Study
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Currently Employed
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Full Time or Part Time Employee
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Job Title
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Scholarship Information

Please Indicate Some Of Your Interests, Hobbies, Or Leisure Time Activities (*)
Please let us know of some of your hobbies or interests
   
Please Indicate Your Reason(s) For Requesting A Scholarship (*)
Please let us know why you are requesting a scholarship
   
Why Are You Interested In Studying Welsh (*)
Please let us know why you are interested in studying Welsh
   
Have You Ever Received A Scholarship From Cymdeithas Madog
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When Did You Receive The Last Scholarship And What Kind Was It
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Scholarship Request

Cymdeithas Madog is able to offer several types of scholarship in 2017. Please read the qualifications for each before applying

  • The Naomi Mergenthal Memorial Scholarship: Applicants must be 22 or younger, and have not won this award previously
  • The Barckley Scholarship
  • Cymdeithas Madog Partial Scholarship: Anyone wanting financial assistance may apply, including those who may have received a scholarship from Cymdeithas Madog previously.
  • Matching Scholarship
   
Check The Scholarship(s) For Which You Are Applying (*)


Please indicate for which scholarships you are applying
   
If you are applying for a matching scholarship, please indicate the name and address of the organization and of the contact person who will be writing the letter pledging funds on your behalf
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Please read the following questions carefully and then indicate whether you understand the appropriate procedures to follow:

   
I Have Read The Frequently Asked Questions Page (Or The Scholarship Information Brochure) And The Instructions Above And Will Comply With The Procedures Explained Therein
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I Understand That A Letter Of Recommendation Must Be Sent To The Scholarship Coordinator By April 1, 2017, In Order For My Application For Scholarship To Be Considered
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If I Am Applying For A Matching Scholarship, My Sponsoring Organization Will Send The Letter Of Recommendation Confirming The Amount Of Money Pledged On My Behalf:
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I Understand That I Must Register For Cwrs Cymraeg And Send A Deposit of $100 USD To The Cwrs Registrar By April 1, 2017 In Order For My Application For Scholarship To Be Considered
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Submit Scholarship Form