2015 Gary Plank Scholarship NOMINATION FORM

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2015 Gary Plank Scholarship
Young Credit Union People Scholarship (WYCUP)
The Gary Plank Scholarship Program is an opportunity for young credit union professionals and volunteers to attend
the 2015 World Credit Union Conference held this year in Denver, Colorado at the Denver Convention Center July
12-15. This exciting event provides a unique perspective of the international credit union movement with highlights
such as: World Council Young Credit Union People (WYCUP) networking sessions, breakout sessions, networking
opportunities and much more. To be considered for a scholarship, one must be 35 or younger on January 1, 2015,
an active credit union employee or volunteer with a credit union organization affiliated with the international credit
union system, demonstrate personal commitment and influence in credit union development, and demonstrate
potential for further influence in the credit union movement.
New this year! Nine $5,000 scholarships will be awarded in 2015 - three from each of our three states!
NOMINATION CHECKLIST
An eligible nomination for the
WYCUP Scholarship includes
these five elements:
• A one-page Nomination Form
completed by the nominee.
• Proof of age (One of the
following: photocopy of
passport, driver’s license, birth
certificate or other official
document.)
• Brief essay (less than 500
words) on this essay title:
Describe how you have
contributed to the development
of your credit union or credit
union organization.
• Letter of recommendation from
the credit union CEO.
• Any additional materials you
wish to be considered by the
Foundation in support of your
nomination. For example:
newsletter articles, press
cuttings, letters of support, etc.
This is not a compulsory
requirement.
All nomination materials become
the property of the Mountain
West Credit Union Foundation
and will not be returned.
ELIGIBILITY REQUIREMENTS
To be considered eligible for the
WYCUP Scholarship, individuals
must:
• Be age 35 years or younger on
January 1, 2015.
• Be actively involved either as
an employee or volunteer with a
credit union or credit union
organization that is affiliated
with the international credit
union system.
• Demonstrate personal
commitment and the ability to
significantly influence credit
union development in his/her
country.
• Demonstrate personal
commitment and potential for
further development within the
international credit union
system.
• Attend the 2015 World Credit
Union Conference and WYCUP
networking session Denver
Colorado, at the Denver
Convention Center July 12-15
UNDER 35 PROGRAM
The WYCUP Under 35
Program has been designed to
run during the duration of the
Institute as an addition to the
World Conference. By registering
as an Under 35 Registrant you:
• Are invited to join the WYCUP
nominees in organized events
including pre-conference
sessions and an awards
ceremony to honor WYCUP
nominees.
SUBMITTING A NOMINATION
Nominations for the WYCUP
Scholarship must be received by
the Mountain West Credit Union
Foundation by May 4, 2015.
Nominations can be submitted by
mail, fax or email:
Dr. Dan Santangelo
Mountain West Credit Union
Foundation
1009 Grant Street
Denver, CO 80203
Fax: 720-479-3421
Email: dsantangelo@mwcua.com
2015 Gary Plank Scholarship
NOMINATION FORM
To be filled out by nominee
1. NOMINEES PERSONAL DETAILS
Name:
E-Mail:
Home address:
Phone:
Date of birth:
Age at 1/1/2015:
I have read and meet the WYCUP eligibility requirements and have submitted all of the required information listed on the
enclosed checklist. (Please sign)
nominee’s signature
2. CREDIT UNION INFORMATION
Contact details of primary* credit union or credit union organization:
*This is the Credit Union or organization that you are employed by or volunteer for;
it is not necessarily the sponsor of your WYCUP nomination.
Name of credit union or organization:
Type of organization (circle one)
Credit Union
Asset Size $
Credit Union Trade Organization
Credit Union Service Organization
Address:
Phone:
E-Mail:
Website:
[ ] Attached is a letter of recommendation from the credit union CEO
Credit Union position(s) held
Current (include dates):
Prior (includes dates):
In 100 words or less, describe your role and responsibilities in your credit union or credit union organization:
3. ADDITIONAL SUPPORTING INFORMATION
In 100 words or less, please use this space to provide any additional information concerning your hobbies, voluntary work or
activities that you believe are relevant to your nomination:
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