Alaska Water Well Assoc. - Scholarship

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
Alaska Water Well Association
P.O. Box 113156
Anchorage, Alaska 99511-3156
Fax

Biographical Information

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:_________________________________________________

Are you a U.S. Citizen? Yes / No

Are you an Alaskan resident? Yes / No

Current Education (attach copy of school transcripts)

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:___________________________________________________________________

Applicants Name:________________________________________________________________

Other Circumstances/Special Considerations

Please explain any unusual circumstances that should be considered regarding your financial situation:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________

Do you plan to work while attending school? Yes / No
Do you plan to pursue a career in the State of Alaska? Yes / No

List any Additional Activities and Work Experience

List activities in which you participated in your school (publications, athletics, music, art, student government, and clubs.
College Activities: include dates participated, offices held, special awards and/or honors

___________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
High School Activities: include dates participated, offices held, special awards and/or honors
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
List community activities in which you have volunteered (e.g. church, crisis hot line, peer groups, hobbies, athletics, chorus)
Volunteer Work: include Agency/Organization name, type of work, dates participated and number of weeks
___________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

Applicants Name: _____________________________________________________________________

List jobs (including summer employment) you have held in the past two or three years
Employment Experience: include job and type of work, employer, approx. dates of employment,
approx. hours per week
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________

Oath (Please read carefully and sign below)

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:_______________________

Mail Application to:
Alaska Water Well Association
P.O Box 113156
Anchorage, Alaska 99511-3156

Fax Application to:
We will keep your application on file until payment is received, upon
which we will notify you of your approved application.
Thank You

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