GREATER OMAHA CHAPTER #116 COLLEGE SCHOLARSHIP APPLICATION

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1 GREATER OMAHA CHAPTER #116 COLLEGE SCHOLARSHIP APPLICATION This scholarship is funded by the Greater Omaha Chapter of the National Association of Women In Construction. It is available to any student pursuing a career in the construction industry. In order to be a recipient, you must be enrolled in a construction related degree program at an accredited institute of higher education at the time of disbursement. We are proud to offer this scholarship and are very grateful to our member firms, donors, and supporters. Applicant: This application form is distributed to various levels of educational institutes, including high school, college, technical schools, and apprenticeship programs. Please complete all sections which apply to you. Type or print using black ink. Use N/A if the question does not apply to you. Appearance and completeness will be considered during evaluation. Mail To: NAWIC Greater Omaha Chapter #116 ATTN: Scholarship Committee 7011 Wood Lane Drive LaVista, NE Application must be postmarked by May 15, PERSONAL INFORMATION Name: Last First Middle Home Address: College Address: At which address can you be contacted in July/August? Home College Telephone: Home College Cellular Address:

2 Present Age: Marital Status: Single/Married (please circle one) Spouse s Name Number of dependents (other than spouse) Relationship and ages of dependents Parent or Legal Guardian s Name Relationship Address (if different from Home Address above): SCHOLASTIC INFORMATION Please provide information below for your education history. Include universities, colleges, technical schools, apprenticeship programs, and high schools as applicable. You do not need to include any education prior to high school. Current: Name, City, and State Attendance (From To) Graduation Date Previous: Previous: Explain any gaps in attendance: If you are planning to attend a different educational institute in the fall than your current information listed above, please list below (in order of preference) Page 2 of 5

3 Institute Name, City, and State Accepted (Y/N) Field of Study (Major): Anticipated Graduation Date (month & year): Are you enrolled in a Cooperative Education Program? schedule. If so, include a copy of your work/class Specify your current, cumulative grade point average and send official grade transcripts for your three most recent quarters/semesters/terms. GPA Check One ( point scale) List your extracurricular activities. Indicate elected offices held, if any. Specify purposes of local organizations: Community Activities: Athletics: Other: Page 3 of 5

4 EMPLOYMENT HISTORY List your full-time employment, summer employment, or other part-time work, briefly explaining duties and responsibilities (beginning with your current or most recent job). If part time work, indicate number of hours worked per week. From To Salary $ Firm s Name and Type of Business Address Position Held and Supervisor s Name Duties From To Salary $ Firm s Name and Type of Business Address Position Held and Supervisor s Name Duties FINANCIAL INFORMATION Father s Occupation Annual Income $ Mother s Occupation Annual Income $ Spouse s Occupation Annual Income $ Including yourself, how many members of your immediate family will be attending a post-secondary education program next year? Page 4 of 5

5 How many are receiving financial assistance in the form of scholarships or grants? Do you have a Basic Education Opportunity Grant (BEOG)? If yes, amount $ Indicate the NET amount of ANNUAL support from the following sources: Indicate your estimated ANNUAL expenses: Summer work $ Tuition $ Part-time work $ Living Expenses $ Loans (total) $ Books $ Scholarships (total) $ Misc. $ Parent/Spouse $ Other $ TOTAL OF ABOVE $ TOTAL OF ABOVE $ Financial support needed $ (Total expenses minus total support above) If no parental support, please explain: ADDITIONAL INFORMATION Why are you interested in a construction industry career, and what qualities will you bring to the construction industry? Applicant Signature Date By signing above, I certify that the information contained is true and correct. I further certify that I fully intend to use this scholarship, if awarded, for the pursuit of a degree in a construction related field of study. Page 5 of 5

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