Amanda J. Mierzwa Memorial Fund Name of the Memorial/Scholarship Fund for which you are applying:* Applicant's Name:* First Last Applicant's Cell Phone:*Applicant's Personal Email:* Applicant's University of Michigan Email:* Applicant's University of Michigan Student ID* Applicant's Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code High School From Which You Graduated?* Why did you choose to attend the University of Michigan?*What is (or will be) your major at U of M?* What are your career goals?*Please list any extracurricular and/or service activities in which you have been involved.*If you are awarded this scholarship and someone asks you to explain who Amanda Mierzwa was, what would you say?*If you are awarded this scholarship, do we have permission to publish your name and some other information (eg., high school, major, etc) about you as the winner?*CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.