Organization of Black Aerospace Professionals Scholarship Application

Transcription

1 Organization of Black Aerospace Professionals Scholarship Application Please select the scholarship you are applying for (check all that apply): FedEx 757/767 Type Rating One United Family Scholarship United Airlines Pilot Scholarship One More Step Scholarship Alaska Airlines Pilot Scholarship Horizon Air Pilot Scholarship Handel & Carmen Wellington Excellence Achievement Scholarship OBAP Duane Moorer Scholarship Sisters of the Skies Flight Training Scholarship Jeppesen Scholarship Delta Difference Scholarship OBAP Edward Horne Scholarship United Airlines Tech Op's Wings Financial Scholarship UPS Pilot Scholarship UPS Stem Scholarship UPS Maintenance & Engineering Scholarship UPS Aerospace Management Scholarship UPS Flight Dispatcher Scholarship Beth Powell and Sean McNeal Scholarship Robert "Rabbit" McCommon Aerospace Dispatch Training Scholarship Robert "Rabbit" McCommon Aerospace Flight Training Scholarship Robert "Rabbit" McCommon Aerospace Maintenance Training Scholarship Brandon Francisco Scholarship APPLICATION INSTRUCTIONS (MUST READ): There is no limit on the number of scholarships that an applicant can apply for as long as the requirements of the scholarship are met. Each scholarship that an applicant applies for must have its own application and all required documentation submitted in one combined PDF file. Attached the ONE COMBINED PDF, to an . The subject line should be the name of your scholarship and your full name. ie, Subject line: Jeppessen/Malcolm Johnson. The body of the must include your name, contact information and OBAP member number. You must be an active OBAP member at the time of submission. The application must be typed, no exceptions. There are several free online services in addition to Acrobat Reader to consider for typing on a PDF. All application requirements must be submitted as one PDF. There are several free online services in addition to Acrobat Professional to consider completed application, following all above steps, to obapscholarships@obap.org no later than 11:59 pm EDT on the deadline date.

2 Please note: partial submissions and failure to comply with instructions could result in disqualification. First Name: _ M.I. Last Name: OBAP Member Number: Address: City: State: Zip Code: Home Phone: ( ) Cell Phone: ( ) Place of Birth: Date of Birth Citizenship_ Sex: M / F We ask that you complete the following optional information so as to allow us to effectively monitor aviation diversity: RACE/ETHNIC BACKGROUND: (Check one) Black/African American American Native/Alaskan Eskimo Asian/Pacific Islander_ Hispanic/Latino White/Caucasian Other (specify) Have you applied for any other OBAP funds previously? YES NO Were you successful? YES NO If yes, date, amount awarded, Name of endeavor / program

3 Do you have FAA violations? Yes No If yes, Please explain: Have you ever received a letter from the FAA regarding your certificate or any other action? Yes No If yes, Please explain: Have you ever been convicted of a felony/misdemeanor? Yes No If yes, Please explain: Have you had any traffic violations? Yes No If yes, Please give place, dates, and disposition: EDUCATION: Check the highest level of Education attained: Diploma/GED: BA/BS Degree: Post Grad Degree: School Address City State Zip Code _ Name of College/University Address: City State Zip Code: Telephone: Name of Flight School Address City State Zip Code Telephone

4 What is your current position? Student Pilot Flight Instructor Military Regional First Officer Regional Captain Other Please indicate your next step in reaching your career goal. Pilots: Flight Instructor Military Pilot Regional Pilot Major 121 Cargo Corporate Other Science, Technology, Engineering, Mathematics, Airport Management, Mechanics and Dispatcher Candidates: Internship Full Time Position Pilot Data: Pilot Certificate# Date of Last FAA Flight Physical List ALL Certificates and Ratings Held: Date of Issuance Class: List ALL Type Ratings Held:

5 EMPLOYMENT HISTORY: (please provide 5 yrs. of employment use additional sheets) Current Employer: Supervisor: Address_ City State Zip Code Position/Title Date of Hire Employer: Supervisor: Address_ City State Zip Code Position/Title Date of Hire Employer: Supervisor: Address_ City State Zip Code Position/Title Date of Hire Describe your volunteer work within the OBAP organization, include dates, length of service, key leaders and your responsibilities:

6 PHOTO RELEASE WAIVER I hereby grant permission to OBAP to take and reproduce photographs and videotapes for publication, including publication by news sources and other sources for all educational, trade, advertising and other purposes as determined by OBAP. The Organization of Black Aerospace Professionals or various other media may choose to take pictures or videotape of participants in OBAP activities. These images may be used for OBAP displays, brochures, newsletters, archives, news releases, publicity and website. Printed Name Signature Date If enrolled in High School or College/University Degree Program, this section must be completed by an advisor or faculty member. Overall GPA GPA in Aviation Classes (if applicable) Printed Name Signature Title Date