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