LAWRENCE SCHACHLE / AWWA MEMORIAL SCHOLARSHIP This scholarship is offered to Alaska resident undergraduates currently enrolled full-time and in good standing at an Alaska college or university pursuing and intending to continue studies in groundwater and groundwater-related fields. Currently this $500 scholarship will be awarded annually to a qualified applicant one time only. To print this scholarship application to mail or fax click "print" on your browser. Instructions and Additional Qualifications: 1. Complete all pages; only complete applications will be considered for award. 2. Three letters of recommendation are required. Choose from 1) school, 2) work, 3) community. 3. Your name must be on all pages of the application. 4. An interview (in person or by phone) may be conducted at our option and expense. 5. Completed application must be submitted to the Alaska Water Well Association (AWWA) Education Committee Chairman on or before May 5th of the year for which fall enrollment is planned. 6. Award of
scholarship will be determined on or before June 30th of the applicable year.
AWWA
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Name:_________________________________________ Social Security Number:____________________________ Home Address:_________________________________________________ H.S. Graduation or Equivalent: Yes / No City/State/Zip:__________________________________________________________________________________ Campus Address:_______________________________________________________________________________ City/State/Zip:__________________________________________________________________________________ Home Phone:_______________________Campus Phone:__________________Work Phone:___________________ Date of Birth:_______________________Place of Birth:_________________________________________________
School You Are Currently Attending:________________________________________ GPA:____________________ Address:________________________________________________________Current Class Standing:____________ City/State/Zip:____________________________________________________Dates Attended:_________________ Dept. Head / Advisor Name:________________________________________________________________________ Academic honors
and/or offices
held:_________________________________________________________________ Extra
-curricular
activities:__________________________________________________________________________
School You Are Planning to Attend:__________________________________________________________________ Location (city/state):_______________________________________________________________________________ Degree Goal:____________________________________________________________________________________ Expected Degree Completion Date (month/year):________________________________________________________ Plans for
Post-Graduate
Education:___________________________________________________________________
Please explain
any unusual circumstances that should be considered regarding your financial
situation: Do you plan to
work while attending school? Yes / No |
List activities
in which you participated in your school (publications, athletics, music,
art, student government, and clubs.
Applicants Name: _____________________________________________________________________ List jobs
(including summer employment) you have held in the past two or three years
To the best of my knowledge, I have provided complete information. I am an Alaskan resident and intend to remain so. I agree to report any factors which could affect consideration of my application. I understand that failure to provide accurate and complete information may void my application. Signature:_____________________________________
Date:_______________________
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