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Foundation Scholarship Application
Missouri Southern State University emphasizes the dignity and equality common to all persons and adheres to a strict nondiscrimination policy regarding the treatment of individual faculty, staff, students, third parties on campus, and applicants for employment and admissions. In accord with federal law and applicable Missouri statutes, the University does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, pregnancy, ancestry, age, disability, genetic information, veteran status, or any other legally-protected class, in employment or in any program or activity offered or sponsored by the University, including, but not limited to, athletics, instruction, grading, the awarding of student financial aid, recruitment, admissions, and housing.
Personal Information
*
Last Name
Middle Initial
*
First Name
*
Do you have a SID (MSSU Student ID#)?
If you do not have a SID enter your Social Security Number
*
Will you be enrolled in 12 or more credit hours?
No
Yes
*
Gender:
Male
Female
*
Are you transgender?
No
Yes
*
Phone:
*
Email Address:
*
Mailing Address:
*
City:
*
State:
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 Code:
*
Are you a current resident of one of these local counties?
No
Barry MO
Barton MO
Dade MO
Jasper MO
Lawrence MO
McDonald MO
Newton MO
Stone MO
Benton AR
Carroll AR
Delaware OK
Mayes OK
Ottawa OK
Cherokee KS
*
Do you live on or off-campus?
On-campus
Off-campus
Ethnicity
*
Ethnicity
(Select One):
Black Non-Hispanic
American Indian or Alaskan Native
Asian - Non Korean descent
Asian of Korean Decent
Hispanic or Latino
Hispanic or Latino - Mexican-American
White Non-Hispanic
Native Hawaiian/Pacific Islander
Multiple Races (Non-Hispanic)
Decline to Answer
Citizenship
*
Are you a US citizen?
I was born a US citizen.
I gained citizenship through naturalization.
I am undocumented and fall under DACA classification.
I am not a US citizen.
3950 Newman Road
Joplin, MO 64801-1595
(417) 781-6778
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