GEORGE M. LAMBERT SCHOLARSHIP PROGRAM APPLICATION

Transcription

1 PERSONAL INFORMATION: GEORGE M. LAMBERT SCHOLARSHIP PROGRAM APPLICATION University Attending: Fall Semester Completion Date: 1.NAME: (Last) (First) (Middle/Maiden) (Mr., Mrs., Ms.) PERMANENT HOME 2.ADDRESS: (Number & Street) (City) (State) (Zip) (Phone No.) COLLEGE ADDRESS: (Number & Street) (City) (State) (Zip) (Phone No.) Which address do you wish correspondence mailed to? Home 3. Date of Birth: College 4. Marital Status: Single Married Plan to Marry Soon Divorced Separated Widowed 5. If married, please provide full name of spouse: 6. Other Dependents Explain 7. If single, total number of children in your family 8. Please list below the names and addresses of two persons in your community whom you are asking to complete the Personal Appraisal Forms attached. (Do not give to relatives.) 1) (Name) (Address) (Position) (Place of Occupation) 2) (Name) (Address) (Position) (Place of Occupation) PIPELINERS VOLUNTARY FUND P.O. Box Tulsa, OK PH: 918/ Fax: 918/

2 GEORGE M. LAMBERT SCHOLARSHIP PROGRAM APPLICATON PAGE 2 9. Are you a member of Local 798? Yes No (If you answered the above question yes, please complete the following blanks) A. Your Union Book Number Initiation Date B. Are you an active supporter of the PIPELINERS VOLUNTARY FUND? Yes No 10. Is your parent a member of Local 798? Yes No (If you answered the above question yes, please fill in the following blanks) A. Name Relationship (Father/Mother/Father-in-Law/Grandfather, Etc.) B. Parent s Union book number C. How long has your parent been a member of this Union? D. Is your parent an active supporter of the PIPELINERS VOLUNTARY FUND? Yes No E. Has your parent signed a Voluntary Fund pledge card? Yes No 11. Is your spouse a member of Local Union 798? Yes No Name of Spouse Union Book Number of spouse Initiation Date A. Is your spouse an active supporter of the PIPELINERS VOLUNTARY FUND? Yes No B. Has your spouse signed a Voluntary Fund pledge card? Yes No II. EDUCATIONAL INFORMATION 1. Names of High Schools and/or Degree Colleges you have attended Location Dates or (Beginning with High School) (City & State) Attended Diploma GEORGE M. LAMBERT SCHOLARSHIP PROGRAM APPLICATION

3 PAGE 3 2. What will be your major area of scholastic concentration? 3. What occupation or profession do you plan to enter after you have graduated from college? 4. What will your college classification be during this coming fall school term? First Semester Fall Semester Second Semester (Fall 2016) Completion Date (Spring 2017) Freshman Sophomore Junior Senior Graduate 5. Grade Average in High School 6. Do you foresee any condition, which may prevent your completing the academic period for which you are applying for financial aid? If so, explain: 7. If you are a First Semester Freshman Student do you plan to complete at least one full year of college? 8. Please attach copies of your official college grade transcripts available to this date and if you are a first semester freshman, a copy of your official high school transcript. DO NOT FORGET, it is your obligation to see that the registrar of your college mails in to the PIPELINERS VOLUNTARY FUND a transcript of your grades immediately upon completion of this current fall semester in which application is being made for a Scholarship Award.

4 GEORGE M. LAMBERT SCHOLARSHIP PROGRAM APPLICATION PAGE 4 III. Essay Question. Please respond to the following question in words. You may use the front of this page or a separately submitted page to complete the essay. Essays should be typewritten and double-spaced. List 5 things Unions have done for America, and explain how each one has affected you personally.

5 PERSONAL APPRAISAL FORM For Person Other Than A Relative The following is my personal, confidential appraisal of 1.Aptitude 2.Reliability 3. Ability to get along with other people 4. Standards of personal conduct and honesty 5. Leadership Ability 6. Special qualities of this student that would contribute to his/her success as a University student Your Profession and position Period of acquaintance with student Please mail this Appraisal Form to: PIPELINERS VOLUNTARY FUND P.O. Box Tulsa, OK Signed Date Address

6 PERSONAL APPRAISAL FORM For Person Other Than A Relative The following is my personal, confidential appraisal of 1.Aptitude 2.Reliability 3. Ability to get along with other people 4. Standards of personal conduct and honesty 5. Leadership Ability 6. Special qualities of this student that would contribute to his/her success as a University student Your Profession and position Period of acquaintance with student Please mail this Appraisal Form to: PIPELINERS VOLUNTARY FUND P.O. Box Tulsa, OK Signed Date Address