WA Governor's Industrial Safety & Health Advisory Board Construction Safety Day Planning Committee

Transcription

1 WA Governor's Industrial Safety & Health Advisory Board Construction Safety Day Planning Committee Scholarship Application PURPOSE OF THE SCHOLARSHIP: Through the generosity of the Washington State Governor's Industrial Safety & Health Advisory Board, Construction Panel, a $1, scholarship is available to assist eligible worthy students in the pursuit of a career as a safety professional. ELIGIBILITY REQUIREMENTS: To be considered, a student must be a resident of Washington State, and meet one of the following eligibility requirements: 1) Be in good standing in the final year of high school 2) Within their first through fourth year of college 3) Or enrolled/enrolling in a recognized safety training program with the intent of becoming a safety professional. APPLICATION PROCEDURES: There shall be no discrimination based on race, color, creed, national origin, age, or sex in the selection process or the administration of the scholarship program. The following general scholarship criteria will be considered in making the selections: 1. Need 2. Anticipated field of study 3. C h a r a c t e r 4. Academic attainments (test scores, grade point average, class ranking) 5. Extra-curricular accomplishments 6. Other (as may seem applicable to the scholarship program in question) FOR MORE INFORMATION CONTACT: Governor's Industrial Safety & Health Advisory Board, Construction Panel Board Member Doug Buman Tukwila International Blvd., Suite 145 Seattle, WA Trifund@unions-america.com Applications also available at:

2 Date Sent: Applications must be received by mail only, before 4 PM on March 15th, 2018 Mailing Address: Governor's Industrial Safety & Health Advisory Board Attn: Doug Buman Tukwila International Blvd., Suite 145 Seattle, WA Scholarship recipient will be notified by US Mail and/or on or before April 2nd, 2018, and will be formally awarded during the 11th Annual Construction Safety Day event on May 11th, 2018, at the Washington State Fair Events Center. (Recipient need not be present) NAME HOME STREET ADDRESS CITY STATE ZIP CODE AREA CODE AND TELEPHONE ( ) DATE OF BIRTH T h e P a n e l m a y o n l y c o n s i d e r a p p l i c a t i o n s w h i c h a r e c o m p l e t e

3 Educational Information The following information MUST accompany your application High School Information: Name of High School which you attend: Address of High School: City: State/Province: Telephone Number (including area code) Date Graduated or will graduate: Are you enrolled in a Head Start or Running Start Program? YES NO The Panel may only consider applications which are complete

4 College, University or Information What College or University do you plan to attend? Address of College/University Are you currently attending this College or University? YES NO If yes, when did you first attend? Have you been accepted as a full time student? YES NO If no, when do you expect to know? Is this College or University a two (2) year or four (4) year institution? Yrs. Anticipated Field of Study: Major: Minor:

5 SCHOOL OR COMMUNITY ACTIVITIES Please provide a summarized description of any extracurricular activities which you have been involved with, your responsibilities as well as the duration of your participation.

6 HONORS AND AWARDS Please list all honors and/or awards which you have received. OFFICES AND POSITIONS OF LEADERSHIP Please list all of the offices and/or positions of leadership which you have held.

7 EMPLOYMENT HISTORY (Start with Present Date, Five Years Minimum)

8 Scholarship Information Please list all of the scholarships which you will be receiving during this academic year, the amount of the scholarship and the number of years for which the award is intended. Name of Sponsor Year Number Amount in which of Years of Award Award Covers Award is For Please list all of the scholarships for which you have applied. Amount Name of Sponsor of Award

9 Applicant's Essay Please provide a typed 300 word essay explaining how and why you came to the decision to pursue a career in safety, and how this scholarship would affect your ability to do such. Letters of Recommendation Please provide the following letters as they apply to you. All letters must be under seal of the author: High School Seniors: One (1) letter of recommendation from your High School Counselor One (1) letter of recommendation from a Teacher. One (1) letter of recommendation from the community. Current College Students: One (1) letter of recommendation from your College Advisor. One (1) letter of recommendation from a Professor. One (1) letter of recommendation from the Community. Currently Enrolled/Enrolling into a recognized safety program with t he Intent of becoming a safety professional: One (1) letter of recommendation from one of your employers One (1) letter of recommendation from a prior safety supervisor One (1) letter of recommendation from the Community WA State Governor's Industrial Safety & Health Advisory Board, Construction Panel Scholarship Application

10 CERTIFICATION AND RELEASE AUTHORIZATION I certify that the information contained in this application is true, complete and accurate; I authorize release of any of this information to confirm and/or verify this application. I further authorize the release of my name and image (photographic or video) to the scholarship grantor for educational and promotional purposes. (Applicant's Signature) (Date) (Parent's Signature, if under 18) (Date) Applications must be received by March 15th, 2018, 4PM Mailing Address: Governor's Industrial Safety & Health Advisory Board Attn: Doug Buman Tukwila International Blvd., Suite 145 Seattle, WA The Committee, in its sole discretion, reserves the right to withdraw or terminate any scholarship in the event of changed circumstances.