NAEA Education Foundation Special Enrollment Exam (SEE) Preparation Section A: Contact Information Name: ______________________________________________________________________ Last First MI NAEA Associate _____ yes _____ no NAEA ID: ________________________________ Is this a: _____ new application or _____ request for continuation of a scholarship for the online course Address: ____________________________________________________________________ City, State, Zip Code: __________________________________________________________ Phone: _____________________________ Fax: ____________________________________ E-mail: ______________________________________________________________________ Important Information Please note, failure to follow instructions may disqualify your application. Guidelines and Qualifications All sections of the application must be filled out. Only complete applications will be considered. Type your response whenever possible. Your initial application must be accompanied by two letters of recommendation. Requests for continuation of a scholarship for the online course do not require letters of recommendation. You must have a high school diploma, GED, or the equivalent. Your initial application must be received and/or post-marked a minimum of two months in advance of the course you plan to attend. Requests for continuation of a scholarship for the online course must be received at least three weeks prior to the start of the course. Scholarships are only given for SEE courses offered through NAEA or NAEA State Affiliates. Scholarships for NAEA’s online SEE Prep course are awarded per part. Scholarships are non-transferable and may only be used for the session offered. Special instructions for NAEA Las Vegas SEE Review Course Applications for the Las Vegas SEE Review course are due by 5:00 pm ET on Tuesday, May 29, 2012. Late applications will not be considered. Scholarship notifications will be emailed no later than June 29, 2012. If you prefer to register for the National Conference before notification and are awarded a scholarship, the amount of your award will be refunded to you. Please keep in mind that the deadline for early-bird, discounted registration for the National Conference is July 9, 2012. All applications are reviewed by the NAEA-EF Scholarship Committee and decisions will be based on financial and career needs as well as background in taxation. Notification will be sent via email to the address shown on this application. Please notify NAEA if your contact information changes. Section B: Education Information Education Completed: o o High School or GED Some College o o Associate Degree Bachelors Degree o o Graduate Degree Masters Degree Course of Study: ________________________________ Section B1: Your Experience in the Field of Taxation ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Section C: Applicants Goals Educational or Professional Goals: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Section D: Financial Information Are you applying for? _____ NAEA’s Online Instructor Led SEE Prep Course Part 1 _____ NAEA’s Online Instructor Led SEE Prep Course Part 2 _____ NAEA’s Online Instructor Led SEE Prep Course Part 3 _____ NAEA National Conference Intensive SEE Review, August 5-7, 2012 In-person education for the very experienced preparer _____ State Affiliate SEE Prep or Review Course State Affiliate offering course: _____________________________________________ Contact person & phone number: __________________________________________ Total Cost of Course and Materials: ________________________________________ Dates of Course: _______________________________________________________ Have you applied for a scholarship from any other source? ____ yes ____ no If yes, from what source? _______________________________________________________ Have you been awarded a scholarship from any other source? ____ yes ____no If yes, from what source? _______________________________________________________ Scholarship funds for NAEA’s Online Instructor Led courses will be automatically applied toward your registration (you must still register for the course on the NAEA registration form). Scholarships for State Affiliate Courses will be paid directly to the State Affiliate. Please provide a copy of the registration form and the contact person for the purposes of transmittal of the scholarship funds (you must still register for the course with the State Affiliate). Funds will only be dispersed to the scholarship candidate if proof of payment is provided and prior approval has been granted. Section E: Applicant Statement Please answer the following questions in 75 words or less: What is an enrolled agent? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Should you pass the exam, how do you intend to use the license? ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Additional information (including financial need) that you would like Committee to consider: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Please tell us how you heard about the NAEA Education Foundation scholarships for the SEE prep. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ I hereby certify that all statements in this application are true to the best of my knowledge and understand that falsification is cause for voiding this application. I have read all of the information and the requirements contained herein and agree to abide by them. Signature_______________________________________Date_________________________ Submit applications to the NAEA-EF SEE Prep Scholarship Program to: Attn: Clarise Diggs, Membership Coordinator 1120 Connecticut Avenue, NW, Suite 460 Washington, DC 20036 Fax: 202-822-6270 Submit applications for the National Conference SEE Review only to: Attn: Holli Jones, Education and Meeting Manager 1120 Connecticut Avenue, NW, Suite 460 Washington, DC 20036 Fax: 202-822-6270