National Association of Women in Construction - DOC by HC120929135534

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									                                                                                                      NATIONAL ASSOCIATION OF WOMEN IN CONSTRUCTION
                                                                                                      SAN DIEGO CHAPTER #21
                                                                                                      2011-12 SCHOLARSHIP APPLICATION
                                                                                                      POSTMARK DEADLINE: MARCH 3, 2012



APPLICANT GENERAL INFORMATION Please print or type.

  Name:
                First                                                             Middle                                   Last Name
  Permanent Mailing Address:
                                          Street                                                                        Apt No.

                                          City                                   State                                  Zip code
  Email Address:
                                                                       Home                                                                            Home
  Telephone Number:          (        )                                Mobile     Alternate Number           (         )                               Mobile

  Birth date:                                                      Gender:              Female          Male
                 Enter in MM-DD-YYYY format.
  Are you a legal U.S. Resident?                   Yes      No
  Marital Status:         Single           Married          Divorced            Other                                      Number of dependents:
  Who do you reside with?                  Parent(s)/Guardian            Other
  Who contributes to your financial support?
  Are you currently employed?                    Yes, part time         Yes, full time           No

FAMILY INFORMATION

  Parent/Guardian:
                         First                                         Last                                            Relationship
  Parent/Guardian:
                         First                                         Last                                            Relationship
  Is a parent/guardian employed in the construction industry in San Diego County?                                Yes         No
  If yes, please provide the following:
  Employer:
  Occupation:                                                                                                               How long?

APPLICANT ACADEMIC STATUS AND SCHOOL INFORMATION

  Are you currently enrolled in an accredited community college or university?                          Yes, part time            Yes, full time       No
  If yes, where are you enrolled?
  If no, will you be enrolled this fall?  Yes                     No
  Name of school where you will be enrolling?
  How many units have you completed?                                   Intended Major/ Area of Study:
  Schools Attended: Please provide a list of schools which you have attended, or are currently attending. List most recent first.
  Use a separate sheet if necessary.
   Name of Institution, and Location                  Major              Dates Attended (From/To)              Graduation Date




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  National Association of Women in Construction
  San Diego Chapter #21
  2011-12 Scholarship Application                                                                                  Applicant’s Name (Last, First)


OTHER SCHOLARSHIPS / RECOGNITIONS

  Scholarships/Grants Awarded: Please list other scholarships/grants for which you have applied or have been awarded:
  Use a separate sheet if necessary.




  Additional Special Awards/Recognitions: Please list additional awards/recognitions. Use a separate sheet if necessary.




ADDITIONAL REQUIREMENTS:
             A recent official academic transcript.
             A minimum of two (2) letters of recommendation.
             A personal statement that provides information regarding your educational, specific career, and personal goals.
             Please include other interests and activities. Information about unique, personal and/or financial circumstances may
             be added. Personal statements must not be more than three pages in length.

SCHOLARSHIP CONSIDERATION:
       I am a male/female student pursuing a college degree who has a parent employed in the San Diego construction industry.
       I am a female student pursuing a college degree in a construction related profession.

CERTIFICATION
  All of the information that I have provided in this application and in the enclosed letter is true and complete, to the best of my
  knowledge. I understand that the provision of false or misleading information may lead to the rescinding of an award. I certify that
  I currently meet the eligibility requirements and will, if awarded the scholarship, provide the Scholarship Committee of the
  National Association of Women in Construction (NAWIC), San Diego Chapter #21with proof of my college registration.

  I hereby authorize NAWIC, San Diego Chapter #21 to use the information contained in this application for the purpose of
  promoting and publishing the Scholarship, or as legally required or permitted by law.

  Applicant Signature:
  (Required)

   Signature                                          Print Name                                   Date

  Parent/Guardian Signature:
  (Required if Applicant is under 18 years of age)



   Signature                                          Print Name                                   Date

  Please mail completed applications to:             NAWIC Scholarship Committee
                                                     c/o Ana Márquez, Gafcon, Inc.
                                                     701 B Street, Suite 1600
                                                     San Diego, CA 92101

                                                     Completed applications must be postmarked on or before the March 3, 2012 deadline.



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