SCHOLARSHIP APPLICATION NOTE: Applications must be received no later than April 15, 2019 The Oregon Chapter of the Chartered Property & Casualty Underwriting Society (CPCU) is proud to provide a $2,000 Scholarship to an Oregon CPCU Chapter Member or an immediate family member of an Oregon CPCU Chapter Member in good standing with the Chapter and National Society of CPCU Immediate family member is defined as a child, stepchild, grandchild, sibling, niece, nephew or person for whom the Chapter Member is a legal guardian The award will not exceed and must only be applied to the applicant's educational costs (tuition, fees, books, and study materials) Eligibility is broad The applicant must be attending, or a high school senior planning on attending an accredited college or university of any nature with no restriction on subject matter Prior recipients of this scholarship will be eligible for a second award and multiple family members may apply Nonwinning applicants are eligible in subsequent years The award will be made by the May Monthly Chapter Meeting (date and time TBD) and all applicants will be notified of their status by that time It is possible that no award will be made in a given year A Volunteer Scholarship Panel of no less than seven (7) Oregon CPCU Chapter members will review each application on a name-blind basis The panel will consider academic achievement, meaningful extra-curricular pursuits and financial need in that order of priority (To be completed by applicant) Applicant’s Full Name Residence: (Street) (City or Town) Phone # Name of Sponsoring CPCU Member: STATEMENT OF APPLICANT I, completely , hereby affirm that I have answered the application questions truthfully and Applicant’s Signature NOTE: ALL QUESTIONS MUST BE ANSWERED AND STATEMENTS SIGNED, OTHERWISE THE APPLICATION WILL NOT BE CONSIDERED This sheet and the requested attachments will be separated from the attached pages once the Scholarship Proctor verifies all documentation Scholarship committee members will review all validated applicants by the Candidate number assigned below Return application to: CPCU Scholarship Committee P.O Box 202 Tualatin, OR (For Internal use only) Candidate Number: _ To be completed by applicant: 1) What recognition have you received in school for scholastic school excellence (e.g honors, prizes, scholarship)? Attach available documentation 2) If full time college/high school student, attach school transcript or other proof of grades 3) Give a brief outline of your immediate education plan: 4) List any extra-curricular activities in which you have taken part (Example: athletics, clubs, yearbook staff, church, civic, fraternal, recreational, charitable or other organizations in which you have been active during the past two years) Mention if you have held office in any such organization and list any special skills or training in any field and how you have applied these skills have or training 5) What are your vocational intentions at the present time? Please be explicit 6) Indicate reasons why you feel you deserve to receive this Scholarship Use separate sheet if necessary 7) List your employment history If High School or College, show employment and average hours worked a week _ 8) If full time college/high school student, what year are you currently completing? If high school student, at what schools have you applied for admission, been accepted or are now attending? 9) Projected educational costs for the upcoming school year (less reimbursements/awards from other sources (scholarships, etc - please be specific) : 10) The space below may be used to enter any additional data you may wish to bring to the attention of the Scholarship Committee, including recommendations ... in school for scholastic school excellence (e.g honors, prizes, scholarship) ? Attach available documentation 2) If full time college/high school student, attach school transcript or other proof... recreational, charitable or other organizations in which you have been active during the past two years) Mention if you have held office in any such organization and list any special skills or training in... Scholarship Use separate sheet if necessary 7) List your employment history If High School or College, show employment and average hours worked a week _ 8) If full