the 2015 Scholarship Form - Richmond

advertisement
AMERICAN SOCIETY OF HEATING, REFRIGERATING AND
AIR-CONDITIONING ENGINEERS, INC.
http://richmond.ashraechapters.org/
ASHRAE – Richmond Chapter
Frederick Weiss / Robert Blue Memorial Scholarships Application
Donor:
The Richmond Chapter of the American Society of Heating and Refrigerating &
Air Conditioning Engineers offers the Frederick Weiss and Robert Blue
Memorial Scholarships. The scholarships range up to $4,000.00 and are
Available at the discretion of the Chapter.
Honorees:
Frederick Weiss was an active member of the Richmond Chapter throughout his
Professional career as a manufacturer's representative. Fred served as a
Regional Chairman and was an active member at the national level as well.
Robert Blue was loyally serving the Richmond Chapter as secretary at the
time of his death in 1998.
Eligibility:
Any student from the Richmond area who is enrolled or will be enrolled in an engineering, science, or
mathematics degree program at a technical, 2-year, or 4-year institution.
Qualification:
Demonstrate a need for financial assistance to complete his/her education with a preference given to
applicants who aspire to work in the field of Heating, Refrigeration, and Air Conditioning. Students who
have a parent that belong to ASHRAE will also be given consideration.
Announcement of Winners:
Winners will be selected at the sole discretion of the Richmond Chapter Scholarship Committee.
Winners will be notified in May 2015.
Contact:
For additional information contact Andy Hobson at (804) 477-4880
or 2009 Roane St. Richmond, VA 23222
or Andy.Hobson@tla-va.com
Page 1 of 4
PERSONAL DATA (Please type or print in ink)
Last Name, First, MI
Preferred Telephone No.
E-mail
Student’s Home Address
City
State
Country
Zip Code
Student's Campus Address
City
State
Country
Zip Code
Date of Birth
Citizenship
Name & Relationship of Family Member belonging to ASHRAE
Are you an ASHRAE student member?
EDUCATION
High School
Location
Year Graduated H.S.
College or University attending in Fall 2015
Location
Major Subject
What is the Basis of the Cumulative Grade Point Average at your School? (i.e., What number does “A” represent?)
Cumulative Grade Point Average
No. of Terms to Complete Degree
CURRICULUM
ACTIVITIES – Activities and Hobbies
Page 2 of 4
Anticipated Month & Year of Graduation
List below any offices held in professional or honorary societies
Office
Society
1.
2.
3.
4.
PROFESSIONAL DATA (Supply a brief resume of your work experience in chronological order)
Job Title
Duties
Length of Employment
Pay Rate
PROFESSIONAL GOALS – Please describe your interest and/or participation in the fields covered by ASHRAE? (Answer 100
words or less)
Describe applicant’s financial need, include cost of education (tuition & room and board), amounts of other scholarships, percent of
expenses that the application is paying versus parents, etc.
Page 3 of 4
*Are you currently receiving financial aid from ASHRAE or other source? If yes, please describe.
Mailing Address of Registrar where Scholarship, if awarded, may be sent:
I believe all of the above information to be true and complete and I hereby apply to the American Society of Heating, Refrigerating and
Air-Conditioning Engineers, Inc. for an ASHRAE Scholarship. I certify that I am not receiving full funding for my education from an
employer, any branch of the Armed Services or other organization. I authorize ASHRAE to obtain and review my academic records
(including but not limited to official transcripts). In signing below, I agree to hold ASHRAE harmless from any and all liability for
damage, injury, or loss sustained by me in connection with this application, including but not limited to, the acquisition by ASHRAE of
my academic records.
Date
Signature of Applicant
Signature of Parent or Guardian (if applicant is under 18 years of age)
APPLICATION DEADLINE:
APRIL 30, 2015
Mail completed application package in one envelope postmarked on or before the deadline with “ATTN:
ASHRAE Student Scholarship” to:
Andy Hobson
2009 Roane St.
Richmond, VA 23222
Phone: 804-477-4880
http://richmond.ashraechapters.org/
Andy.Hobson@tla-va.com
Page 4 of 4
Download