CPCU Scholarship OR Chapter Application 2019

SCHOLARSHIP APPLICATION
NOTE: Applications must be received no later than April 15, 2019

The Oregon Chapter of the Chartered Property & Casualty Underwriting Society (CPCU) is proud to
provide a $2,000 Scholarship to an Oregon CPCU Chapter Member or an immediate family member
of an Oregon CPCU Chapter Member in good standing with the Chapter and National Society of
CPCU. Immediate family member is defined as a child, stepchild, grandchild, sibling, niece, nephew
or person for whom the Chapter Member is a legal guardian. The award will not exceed and must only
be applied to the applicant's educational costs (tuition, fees, books, and study materials).
Eligibility is broad. The applicant must be attending, or a high school senior planning on attending an
accredited college or university of any nature with no restriction on subject matter. Prior recipients of
this scholarship will be eligible for a second award and multiple family members may apply. Nonwinning applicants are eligible in subsequent years. The award will be made by the May Monthly
Chapter Meeting (date and time TBD) and all applicants will be notified of their status by that time. It is
possible that no award will be made in a given year.
A Volunteer Scholarship Panel of no less than seven (7) Oregon CPCU Chapter members will review
each application on a name-blind basis. The panel will consider academic achievement, meaningful
extra-curricular pursuits and financial need in that order of priority.
(To be completed by applicant)
Applicant’s Full Name
Residence:
(Street)

(City or Town)

Phone #
Name of Sponsoring CPCU Member:

STATEMENT OF APPLICANT
I,
completely.

, hereby affirm that I have answered the application questions truthfully and

Applicant’s Signature

NOTE: ALL QUESTIONS MUST BE ANSWERED AND STATEMENTS SIGNED, OTHERWISE THE
APPLICATION WILL NOT BE CONSIDERED.
This sheet and the requested attachments will be separated from the attached pages once the Scholarship
Proctor verifies all documentation. Scholarship committee members will review all validated applicants by the
Candidate number assigned below. Return application to:
CPCU Scholarship Committee
P.O. Box 202
Tualatin, OR
(For Internal use only)
Candidate Number: ___________


To be completed by applicant:
1) What recognition have you received in school for scholastic school excellence (e.g.
honors, prizes, scholarship)? Attach available documentation.

2) If full time college/high school student, attach school transcript or other proof of grades.
3) Give a brief outline of your immediate education plan:

4) List any extra-curricular activities in which you have taken part (Example: athletics, clubs, yearbook
staff, church, civic, fraternal, recreational, charitable or other organizations in which you have been
active during the past two years). Mention if you have held office in any such organization and list
any special skills or training in any field and how you have applied these skills have or training.

5) What are your vocational intentions at the present time? Please be explicit.

6) Indicate reasons why you feel you deserve to receive this Scholarship. Use separate
sheet if necessary.

7) List your employment history. If High School or College, show employment and average
hours worked a week.

_____________________________________________________________________________


8) If full time college/high school student, what year are you currently completing? If high school
student, at what schools have you applied for admission, been accepted or are now
attending?

____________________________________________________________________________
9) Projected educational costs for the upcoming school year (less reimbursements/awards from other
sources (scholarships, etc. - please be specific) :

10) The space below may be used to enter any additional data you may wish to bring to the attention of
the Scholarship Committee, including recommendations.