Teacher Scholarship Application

TEACHER SCHOLARSHIP APPLICATION

PERSONAL INFORMATION:

Name:

Home Address:

Home Phone Number:

Email Address:

EDUCATION DATA:

Current Enrollment -
	College/University Name:
	College/University Address:
	Beginning year:
	Expected Date of Completion:
Previous College/University Enrollment -
	College/University Name:
	College/University Address:
	Beginning year:
	Date of Completion:

TRANSCRIPTS:

Most recent education transcripts should be mailed in.

PERSONAL STATEMENT:

Please explain your college and career goals, as they pertain to special needs children. This statement should be at least 250 words. Please ensure that you include your selected area of study, your academic goals in your educational program, the specific occupation or profession you intend to enter upon program completion and lastly, include how children with special needs have affected your life to date. Please attach your statement.

REFERENCE LETTERS (please mailed in):

Two letters of recommendation are required. At least one of the letters should be from a faculty member who is familiar with your educational program. Faculty recommendation must be on college/university letterhead. The references should comment on your character and potential leadership, or making a significant contribution to children with special needs. This can be based upon specific examples drawn from your course work, projects or activities. A confidential recommendation is not required. Each letter of recommendation must be signed by the person making the recommendation. Please attach the letters to this application.

Reference 1 Name:	Reference 2 Name:
Institution Name:	Institution Name:
Name of Dept.:	Name of Dept.:
Telephone Number:	Telephone Number:
Email:	Email:

Outreach Programs
R4R Youth Fitness Application
Teacher Scholarship Application

Runnin' for Rhett - 5117 Worcester Way - 916.691.2311
A Non-Profit Foundation (501c3) - Tax ID #26-1419222