Blanche Fierstein Scholarship 2018 APPLICATION BLANCHE FIERSTEIN

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Blanche Fierstein Scholarship 2018 APPLICATION BLANCHE FIERSTEIN Blanche Fierstein will be remembered as an uncompromising leader in the field of special education whose singular vision and ability to inspire others shaped special education curricula and created unprecedented opportunities for people with special needs. Blanche was an educator, mother and tireless advocate. Her own daughter with special needs inspired her to become a special education teacher. Quickly rising through the NYC Department of Education, Blanche was appointed as Principal of the Queens Occupational Training Center. There she was at the forefront, creating practical curricula and quality standards in vocational training. Her groundbreaking work and tireless resolve helped shape vocational training across New York State. She brought the same dedication to her volunteer service as she did to her professional life. She served as an officer of AHRC Nassau s Board of Directors for 10 years, as well as serving as a Board Member of AHRC New York City for more than 35 years, including 3 years as its President. She became a Lifetime Member of NYSARC in 1951, serving on numerous NYSARC committees and eventually serving as President of NYSARC for an unprecedented 13 years. Blanche played an integral role as a parent advocate for the implementation of Governor George Pataki s innovative New York State CARES initiative. She had a gift in articulating the deepest aspirations of individuals, families and parents. Blanche s powerful and poignant words inspired others to take action. We brought light into the dark places. Our children are celebrated not tolerated. We dared to dream for our children and we realized the power of that dream. Our children participate in the American experience. The test is to insure that this continues. We face that challenge together. The Blanche Fierstein Memorial Scholarship seeks to commemorate the extraordinary contributions of Blanche Fierstein by its support of exceptional candidates pursuing advanced degrees in the field of special education.

Application for 2018 Blanche Fierstein Scholarship Instructions General Information The Blanche Fierstein Scholarship was established in 2011 in honor of Blanche Fierstein. The Scholarship is granted annually to people pursuing an advanced degree in special education. The Scholarship The Blanche Fierstein Scholarship is awarded annually to a person pursuing an advanced degree (graduate or post-graduate level only) related to special education. The Scholarship is in the amount of $5,000. Who is Eligible? Persons enrolled in college or university in Nassau County pursuing an advanced degree in special education. Employees of AHRC Nassau who have been employed for a minimum of one (1) year pursuing an advanced degree in special education. AHRC Nassau Lifetime Members pursuing an advanced degree in special education. Students must be registered in an appropriate graduate degree program when funds are received in September. Applicants must also have the ability to demonstrate a commitment to serving the special needs community through activities such as volunteer work, professional development, and/or their current position. How Do I Apply? Complete the enclosed application (may be printed or downloaded from the AHRC Nassau website, www.ahrc.org) and include: Biographical information requested in the application Plans for intended study List all universities/colleges attended, including undergraduate institutions and degrees received Employment history Other experience and activities as requested on the application Two essays on academic program, experience and professional goals - Applicant should discuss the factors that influenced your commitment to serving people with special needs through education. Be sure to answer both essays. A minimum of two original, signed letters of recommendation in sealed envelopes Verification of Enrollment form signed and stamped from the university/college registrar (see page 9 of this application). Information other than letters of recommendation should be limited to the requested length; other attachments are not requested and will not be considered. 2

What is the Application Process? The Blanche Fierstein Scholarship Committee reviews the applications and recommends recipients to AHRC Nassau Board of Directors. All applicants will be notified of their status by May 18 th. How may I use the Scholarship Funds? The Scholarship may be used for tuition and fees. 1. The payment of $5,000 will be forwarded to the bursar s office of the Scholarship winner s designated school. 2. Recipients are not permitted to defer the Scholarship. 3. The recipient may accept additional grants and scholarships from other sources. Deadline Applications are accepted by mail only. Original letters of recommendation must be sealed in separate envelopes and mailed along with the application form and original Verification of Enrollment form. All application materials for the 2018 Blanche Fierstein Scholarship must be received or post-marked by April 30, 2018 to be considered. Applications that are incomplete or late due to postal delays will not be considered. Mail required documents to: AHRC Nassau Blanche Fierstein Scholarship Award Committee 189 Wheatley Road, #3 Brookville, NY 11545 Questions regarding this application may be emailed to fiersteinaward@ahrc.org. 3

Application for 2018 Blanche Fierstein Scholarship Check the appropriate box(es): I am an employee of AHRC Nassau for at least one year. I am a Lifetime Member of AHRC Nassau. I am pursuing my advanced degree at college or university located in Nassau, NY Name: Last (Family) First Middle Present Mailing Address: City: State: Postal Code: Country: E-mail Address: Telephone: Birthdate: Birthplace: Country of Citizenship: Other information, if desired (marital status, children, etc.): Plans for graduate study with the Blanche Fierstein Scholarship: Degree sought: Department/Major/Field of Study: Specific program/thesis: Name of University/College/Institution at which studies will be undertaken: Academic Background If you are selected as a recipient of the Blanche Fierstein Scholarship, you may be required to provide official transcript(s) from previous educational institutions you have attended. In the table below please list the institutions you have previously attended for postsecondary education: University/College (Year) to (Year) Major Field Final GPA Degree Date Degree Received/ Anticipated 4

Employment History List your employment history, including your current position. From (Month/Year) To (Month/Year) Employer Address Type of Work or Position Held Commitment to People with Special Needs Describe any personal experiences, if any, working with persons with intellectual or other developmental disabilities. Please limit remarks to approximately 750 words (the applicant can attach a separate sheet to the application if so desired): 5

Other Activities Please give a description of your related volunteer work and non-scholastic activities. Volunteer Work Non-Scholastic Activities Letters of Recommendation Please submit a minimum of two original and signed letters of recommendation from people who can assess your ability to succeed in the special education field. These references are to be confidential and enclosed in a sealed envelope signed by the person providing the recommendation. Please list below those who will submit recommendations: 1. Name Title Affiliation 2. 3. 6

Essay: Professional Information and Goals In approximately 1,000 words, please discuss the factors that influenced your commitment to serving people with special needs through education (the applicant can attach a separate sheet to the application if so desired). 7

Declaration by Applicant I declare that I will take responsibility for school expenses (such as living, traveling, clothing), which are in excess of the $5,000 Scholarship. If selected as a scholarship recipient I will inform AHRC Nassau of any changes that will affect my ability to undertake my course of study. If selected as a scholarship recipient, I also grant permission to AHRC Nassau to use my name and photograph in literature and on web platforms designed to promote and/or inform regarding the Blanche Fierstein Scholarship. I waive any right to review the letters of reference and attest these letters have been written in confidence. (Signature) (Date) How did you learn of the Blanche Fierstein Scholarship? (Please check the appropriate items.) Checklist to be completed by applicant Recommendations (a minimum of two) Verification of Current Enrollment Form Application completed in full Signature 8

Verification of Enrollment Form Blanche Fierstein Scholarship I certify that (Name) is currently in and is enrolled in a (department) at (graduate) (university/college) Degree program. (Signature of registrar) (Date) (Expected graduation date) (Official University/College Stamp) 9