Central Jersey CPCU Scholarship 2018

Fri, 03/09/2018 - 11:52
by Ryan Burke, CPCU

1. About the Applicant: 
Name: __________________________                                                                                  Address: __________________________________________________________________________   City                    Street         State  ZIP Code    Date of Birth: ___/___/_____                 
Home Phone: (_____) _____-________                   
SS#:  _____-____-_______       
2. Family member that is currently an active member of the Central Jersey CPCU chapter: 
Name: __________________________                                                                   
Address: __________________________________________________________________________   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. 
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 organization. 
9. Have you any special skills or training in any field? If so, please provide a brief description. 
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. 
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 space.)  
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: ___/___/_____                       

Comments (1)

mikee717's picture
This Scholarship Application is available under Documents, Members Only.
2 years 6 months ago