SCHOLARSHIP APPLICATION

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1 Assciatin f State Dam Safety Officials UNDERGRADUATE SCHOLARSHIP APPLICATION SUBMIT APPLICATION AND ATTACHMENTS POSTMARKED BY MARCH 31, 2016 TO: Assciatin f State Dam Safety Officials 239 S. Limestne Lexingtn, KY (855) Fax: (859)

2 ASSOCIATION OF STATE DAM SAFETY OFFICIALS BACKGROUND The Assciatin f State Dam Safety Officials (ASDSO) was funded in 1984 with these stated gals: T prvide a frum fr the exchange f ideas and experiences n dam safety issues. T fster interstate and inter-gvernmental cperatin in dam safety. T prvide infrmatin and assistance t state dam safety prgrams and t the ASDSO membership. T prvide representatin f state interests befre Cngress and federal agencies respnsible fr dam safety. T imprve the efficiency and effectiveness f state dam safety prgrams. Recgnizing that ne f the keys t achievement f these gals is the develpment f well-trained technical persns with an interest in ne f the many scientific fields related t dam safety, ASDSO established its Dam Safety Schlarship Prgram in THE SCHOLARSHIPS Schlarships will be awarded fr the 2016/2017 schl year and have ranged frm $5,000 t $10,000 in recent years. Successful recipients must be U.S. citizens and enrlled full-time at the senir level (during the 2016/2017 schl year) in an accredited civil engineering prgram, r in a related field as determined by ASDSO, and must demnstrate an interest in pursuing a career in hydraulics, hydrlgy r getechnical disciplines, r in anther discipline related t the design, cnstructin and peratin f dams. Undergraduate students planning t graduate in May/December 2017 will be eligible fr the 2016 schlarship. Minimum Criteria - Applicants must have a cumulative grade pint average f 2.5 fr the first three years f cllege and be recmmended by their academic advisr. They must als submit a typewritten essay n the tpic: What is ASDSO and why is dam safety imprtant. Basis fr Award - The basis fr selectin will generally fllw these guidelines: Academic Schlarship Financial Need Wrk Experience/Activities Essay ASDSO will be the final determiner in each instance as t which applicants will be recipients f a schlarship. Final Applicatin Date - Applicatin frms can be btained by writing t ASDSO at the address belw and must be pstmarked n later than March 31, Annuncement f successful candidates will be made in July WHERE TO SEND APPLICATION Send all applicatins and accmpanying materials t: Assciatin f State Dam Safety Officials 239 S. Limestne Lexingtn, Kentucky Questins call: (855) Fax: (859) Additinal applicatins are available n ASDSO s web site:

3 ASSOCIATION OF STATE DAM SAFETY OFFICIALS SCHOLARSHIP APPLICATION A. APPLICATION INFORMATION: Expected Graduatin Date Name (Mr. r Ms.) Permanent Mailing Address City State Zip Temprary Mailing Address City State Zip ( ) Permanent Phne Number ( ) Cell Phne Number address where we can cntact yu in July 2015 Student Member f ASDSO? Yes N Date f Birth Are yu a U.S. Citizen? Yes N B. ACADEMIC ADVISOR: Name Title (if applicable) Address Phne City State Zip Address C. EDUCATIONAL INFORMATION: Cllege r University Dates Majr Field f Study Previus Degree(s) Received Grade Pint Average (fr all cllege curses) Class Rank Have yu previusly been awarded a schlarship, fellwship r grant? Yes N If yes, where? Amunt? D. ATTACH THE FOLLOWING TO THIS APPLICATION: 1. Transcripts f all university educatin (up thrugh Fall 2014 semester) 2. Three letters f recmmendatin, ne f which must be frm the academic advisr (Cpy the attached Reference Frm as needed.) 3. Essay including prpsed curriculum f study E. ESSAY:

4 Prepare a typewritten essay f apprximately 500 wrds n the tpic: 1) What is yur prpsed curriculum f study?, and 2) What is ASDSO and why is dam safety an imprtant field f practice?. Place the title and yur name at the tp f the page. F. CONFIDENTIAL FINANCIAL ANALYSIS: This sectin shuld be cmpleted by the parent, guardian, r applicant (if self-supprting). If this sectin is nt cmpleted, it will be assumed that n financial need exists. 1. Family's Grss Annual Incme $ and Net Taxable Incme $ fr year (as reprted t the IRS). 2. Number f ther children wh will be in cllege during the next fur years, and the estimated annual amunt t be cntributed by the family tward their educatin (exclude the applicant). 3. Infrmatin n Applicant's Father: Name Living? Yes N Address City State Emplyer Occupatin 4. Infrmatin n Applicant's Mther: Name Living? Yes N Address City State Emplyer Occupatin 5. Infrmatin n Applicant if Self-Supprting: Emplyer Occupatin 6. Name f individual wh supprts the applicant 7. Annual Educatin Csts 8. If the individual named in #6 is smene ther than Applicant's father r mther, please cmplete the fllwing: Relatinship f Individual t Applicant Address City State Emplyer Occupatin I hereby certify the abve infrmatin accurately reflects my current financial status. Signature f Parent, Guardian r Applicant Date

5 G. ACTIVITIES: Wrk Experience. List the jbs (including part-time and summer jbs) yu have held since entering cllege. 1. Emplyer 2. Emplyer 3. Emplyer 4. Emplyer Activities. List yur n-campus and ff-campus extracurricular activities (ther than jbs), in the rder f interest t yu, in which yu have been invlved since entering cllege. (Please cntinue n a separate sheet if required). 1. Activity Yur Mst Significant Cntributin 2. Activity Yur Mst Significant Cntributin 3. Activity Yur Mst Significant Cntributin 4. Activity Yur Mst Significant Cntributin Prfessinal Activities and Memberships. List prfessinal activities and memberships (ther than jbs) in which yu have been invlved during cllege. (Please cntinue n a separate sheet if required.)

6 1. Activity r Membership Yur Mst Significant Cntributin 2. Activity r Membership Yur Mst Significant Cntributin 3. Activity r Membership Yur Mst Significant Cntributin Hnrs. List and describe any special hnrs and schlarships yu have wn, either in r ut f schl, since yu have entered cllege. (Please cntinue n a separate sheet if required.) H. Additinal Infrmatin ASDSO wuld like t knw hw yu heard abut this schlarship cmpetitin in rder t imprve student utreach cmmunicatin. Please mark all that apply: Facebk Twitter LinkedIn FastWeb Schlarships.cm Prfessr r advisr (please prvide name) Emplyer (please prvide name f cntact) Other (please describe) Signature Date Assciatin f State Dam Safety Officials 239 S. Limestne Lexingtn, KY (855) Fax: (859)

7 ASSOCIATION OF STATE DAM SAFETY OFFICIALS SCHOLARSHIP REFERENCE FORM Name f Applicant: Instructins t the writer: Please state belw yur pinin f the applicant's abilities as a student r emplyee and ptential fr future leadership in the field f dam engineering and safety. Any additinal cmments yu might wish t make are welcme. When yu have cmpleted the frm, please place it in an envelpe, seal the envelpe, sign yur name acrss the sealed flap t ensure cnfidentiality, and give the envelpe t the applicant s the applicant can return a cmplete applicatin. Date applicant can be expected t cmplete degree requirements: Institutin ( ) Telephne Number Date Signature Name (printed r typed) Psitin r Title Address

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