Central Jersey CPCU Scholarship 2017

Thu, 02/23/2017 - 16:06
by Mike Pawelczak

Instructions for CPCU Society Scholarship Grant Application

Please submit the following by April 15, 2017:

 A completed Scholarship Grant Application.
 Transcript of high school or college grades as of the end of the current school year.
The transcript should cover at least two prior academic years and all college work.
 A copy of the Scholastic Aptitude Test (SAT) scores. Please note in ITEM #14 of the
application if you were not required to take the SAT.
 Two letters of recommendation from the persons listed in ITEM #12 of the application,
sent by the deadline under separate cover, to the address below.
o One letter from a teacher.
o One letter from a guidance counselor.

All of the above materials should be sent to:
Ryan Burke
Corporate Communications Dept.
NJM Insurance Group
301 Sullivan Way
West Trenton, NJ 08628

All applicants will be notified of the results by May 15, 2017.


CPCU Scholarship Grant Application - Page 1 of 3

Central Jersey Chapter, CPCU
Scholarship Grant Application

1. About the Applicant:
Name: __________________________
City Street State ZIP Code

Date of Birth: ___/___/_____
Home Phone: (_____) _____-________
2. Family member that is currently an active member of the Central Jersey CPCU
Name: __________________________
City Street State ZIP Code

3. School in which presently enrolled or attending and your status. (freshman,
sophomore, etc.)

School Status

4. At which school have you been accepted and plan to attend?

School Status

5. What recognition have you received in school for scholastic excellence (i.e. honors,
awards, etc.)?


6. Do you believe that your present and recent grades in high school and/or advanced
education reveal fairly and accurately your ability to do the work required at a higher
level of education? If not, please explain.


CPCU Scholarship Grant Application - Page 2 of 3

7. List any extra-curricular activities in which you have taken part. (i.e. year book staff,
athletics, clubs, etc.)


8. List any religious, civic, fraternal, recreational or other organizations in which you
have been active during the past two years. Mention if you have held an office in the


9. Have you any special skills or training in any field? If so, please provide a brief


10. What are your career goals at the present time? Please be specific.


11. Indicate the reason(s) you feel you deserve this scholarship.


12. List the name of one teacher and one guidance counselor who you have asked to
send a letter of recommendation to the Selection Committee.



Guidance Counselor



CPCU Scholarship Grant Application - Page 3 of 3

13. List any employers and the average number of hours worked per month.
Employer name Address Hours per month


Employer name Address Hours per month


Employer name Address Hours per month


14. Provide any additional information you wish to bring to the attention of the
Selection Committee. (Please note if you were not required to take the SAT in this


I hereby affirm that I have completed this entire application, have not been a recipient of full
financial aid and have answered the questions truthfully.

Signature of Applicant: ___________________________________ Date: ___/___/____

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