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Cover page Page 1 of 1 Dear James A. Todd Memorial Scholarship Applicant: The Kansas State Firefighters Association Auxiliary, Inc. is pleased to offer scholarships to State of Kansas Firefighters and members of their families. The Memorial fund is named for a long-time advocate of Kansas Fire service James A. Todd. The scholarships available are the Academic Assistance, Firefighters Assistance and Fire Science. Those eligible for the Academic Assistance Scholarship are Kansas Firefighters (paid, part-paid or volunteer) and immediate family (spouses, children, step-children, natural and adopted grandchildren who will be attending college full-time). Those eligible for the Firefighters Assistance Scholarship are Kansas Firefighters (paid, part-paid or volunteer). Those eligible for the Fire Science Assistance Scholarship are (Fire Science students who do not have fire affiliation but who are attending college full time in the fire science classes). Enclosed please find a KSFFA Auxiliary, Inc. James A. Todd Memorial Scholarship Application. Please take note that your completed application must be post marked by March 1 st of the current year in order to be eligible for the coming school year. Also you must provide a copy of your school transcripts from current High school (if incoming freshman) or most current college transcripts for all college students, in order to be considered for these scholarships. In addition, you must obtain TWO (2) letters of recommendations, One must come from an executive officer of your local fire department on official letterhead (cannot be a family member or member of the State Executive board or Auxiliary board) and the other letter of recommendation must come from outside the fire department. Please mail your completed application to: Pam Brown Kansas State Firefighters Association Auxiliary Scholarship Trustee 1111 Cavesprings El Dorado, Ks. 67042 PLEASE NOTE THAT INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. ONLY APPLICATIONS WITH THE REVISION DATE OF October 2014 WILL BE ACCEPTED. Scholarship recipients will be notified prior to the Auxiliary s Annual Conference in April. Should you have any questions or need further assistance, please don t hesitate to contact me or any of our State Officers. Sincerely,

Pam Brown KSFFA Auxiliary Scholarship Trustee pammax@cox.net 10/1/2014 Application Page 1 Kansas State Firefighters Association Auxiliary Check ONLY ONE Scholarship for which you are applying: Academic Assistance $1,000 Annual Award (full time students) Firefighters Assistance $1,000 Annual Award (firefighters only) Fire Science $1,000 Annual Award Full Name: Address: City, State: Zip: Social Security Number: Parent(s) or Legal Guardian s Name(s): Address (if different from above): Home Phone Number: Birth Date: High School: GPA: Year Graduated: College/University: City, State: Dates Attended: Major: GPA :_ College/University: City, State: Dates Attended: Major: GPA :_ Please list any EXTRA CURRICULAR OR COMMUNITY ACTIVITIES you may be involved in (organizations, honors, awards, as well as any offices held). Continue on an additional page(s) if necessary.

Application Page 2 PERSONAL STATEMENT: In your own handwriting, please state why you feel you are qualified for this scholarship. Indicate your goals for the future and how this will benefit you. Attach a separate sheet if necessary

Application Page 3 FUTURE EDUCATIONAL PLANS: College/University you are planning to attend. Also state any previous colleges/universities you have attended. Name of College/University: Address: City: State: Zip: Major Course of Study: Total Credit Hours earned to date: GPA: Total Attempted: Average hours take per semester: Planned for the NEXT Semester: Previous College(s): Dates: Dates: If there is any additional information which you feel is important for the Selection Committee to know that was not covered in this application. Please indicate YOUR involvement with Fire Department and/or Fire Department Auxiliary functions. Applicant s Signature: Date: Parent s Signature: Date: (If applicant is under 18)

Application Page 4 RECOMMENDATION ON OFFICAL LETTER HEAD: TO THE EXECUTIVE OFFICER: Please consider some of the following when writing this recommendation: character, family, qualifications, financial need, involvement in Fire Department activities, and/or extenuating circumstances.

Application Page 5 SECOND RECOMMENDATION: TO THE INDIVIDUAL: Please consider some of the following when writing this recommendation: character, family, qualifications, financial need, involvement in Fire Department activities, and/or extenuating circumstances. Signature: Date: City,State,Zip: