Scholarship Application Continuing Education

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Scholarship Rules Applicant is applying for one non-renewable $500 scholarship. 1. Applicant must be a U.S. citizen. 2. Applicant must be an active member of the FFAM. 3. Applicant must write and attach to the application a 500 word essay describing how they will benefit from continuing their education and their need for financial assistance. 4. Applicant must submit three letters of reference from someone other than family members. One letter of reference must come from the Chief of their member department. Include contact information for those submitting the letters of reference (i.e. telephone number, address, etc.). 5. Applicants who received a 1 st Year Scholarship are eligible to apply for a Continuing Education Scholarship. 6. If awarded, funds must be used toward continuing education courses in a firefighting or emergency response field, and through an accredited institution for: a) An accredited certification or licensing b) CEU s to be applied toward an accredited certification or licensing AND/OR c) Continuing education at a college or university in Missouri *If applying for the scholarship for continuing education at a college or university, the applicant s degree program does not have to be firefighting or emergency response related. Applications will be accepted until midnight, February 28 of each year and should be submitted to: Fire Fighters Association of Missouri Grant Oetting, Scholarship Committee Chair PO Box 1153 Warrensburg, MO 64093 The scholarship funds will be applied directly toward the recipient s account at the designated college/university/training institution after verification of enrollment is received by the FFAM Secretary. Scholarship funds can be used for tuition, books, supplies and equipment required for courses at the educational institution. The FFAM reserves the right to verify proof of acceptable expenditures of the scholarship funds (i.e. receipts, etc.). Page 1 of 6

The recipient has six months from the award date to present required enrollment information to receive the scholarship funds. In the event that the recipient fails to enroll at their designated college/university/training institution within six months of the award date of the scholarship, the scholarship will be forfeited and awarded to a runner-up recipient. Should a recipient change their designated college/university/training institution subsequent to receipt of the scholarship award, the scholarship may be rescinded by the Scholarship Committee if, in its sole discretion, it determines that the change would have had a material effect on its decision to award the scholarship in the first place. Any interpretations, determination and/or disputes not referenced herein will be addressed and resolved by the Scholarship Committee which will have sole discretion with respect to the scholarship program for the Fire Fighters Association of Missouri. Scholarship recipients will be announced at the FFAM convention of each year following the application deadline. Page 2 of 6

Date of application: PERSONAL INFORMATION Name: Address: City: State: Zip: Telephone: Email: OFFICE USE ONLY Date received: Time: Received by: Applicant number: Page 3 of 6

EDUCATIONAL INFORMATION College/University/Training Institution enrolling at: Planned field of study: Type of program in which you plan to enroll: Bachelor Associate Technical/Trade Certification CEU Planning to enroll: Full-time Part-time Other COMMMUNITY/CIVIL INVOLVEMENT List current organizations or any community involvement that you have been a part of: What fire department are you a member of? Are you a member of the FFAM? Yes No Page 4 of 6

FINANCIAL AID INFORMATION Income and asset data Expenses estimated cost of education per year Tuition and fees Room and board (if applicable) Books and supplies (if applicable) Transportation (if applicable) Amount TOTAL EXPENSES A Income Federal, state, grants, scholarships and other awards. List loans and work study in next section. List additional on separate page. Name of grant or scholarship and amount TOTAL GRANTS/SCHOLARSHIPS B Page 5 of 6

Loans, work study or department assistance Name of source Amount TOTAL LOANS, WORK STUDY, DEPT ASSISTANCE C TOTAL INCOME (B + C) FINANCIAL NEED (A D) D E I certify that the information I have furnished is correct and complete to the best of my knowledge and understand that it may be subjected to verification by the FFAM. I understand and agree that misrepresentation, falsification or omission may be considered sufficient cause for rejection. Signature: Date: Page 6 of 6