Mid-West Concrete Industry Board (MCIB) & Concrete Promotional Group (CPG)

SCHOLARDSHIP APPLICATION

Mid-West Concrete Industry Board (MCIB) & Concrete Promotional Group (CPG)

The Mid-West Concrete Industry Board/Concrete Promotional Group has established a perpetual fund known as the Midwest Concrete Industry Board Educational Fund. The Fund is an endowment fund that will provide financial assistance as follows: Gold Award is awarded to college engineering students pursuing a Bachelor of Science or higher degree that includes concrete and concrete design courses as an integral part of their degree program. Silver Award is awarded to students enrolled in accredited Bachelor of Science or Associates of Science degree programs in Construction Management, Construction Technology or Engineering Technology.

Types and amounts of aid shall be granted at the discretion of the Board of Directors of The Greater Kansas City Community Foundation and may include, but are not necessarily limited to: funds for tuition, books, supplies, projects, or special needs. Student concrete projects associated with their degree program may be considered for assistance. Financial assistance will be awarded based on available funds.

Grants may be based on any of the following: financial need, academic achievement, curriculum, growth, character, leadership capacity, and career interest.

Application RequirementsGold Award:

1.Applicant’s permanent residence as indicated on college records or the high school of record must be within the states of Kansas or Missouri and either (a) within a 150-mile radius from a point on the Kansas/Missouri state line at highway 1-35; or (b) within a 25-mile radius of the main U.S. Post Office at the mailing address of a current MCIB/CPG member.

2.Applicant must be pursuing a Bachelor of Science or higher degree that includes concrete and concrete design courses as an integral part of their degree program at an accredited college or university.

3.Applicant must be enrolled in or have completed concrete or concrete design courses, or completed at least 60 credit hours toward their major degree.

4.Applicant must not be a son, daughter, grandson, granddaughter, niece or nephew of an Advisory Committee member.

5.Part-time student applicants will be limited to junior class status or above. The scholarship award to part-time students will be commensurate with the costs.

6.The application must be typewritten. Responses to questions on the application must be answered on the form, with the exception of the essay question, which may be typed on a separate sheet and attached to the application. The application must be accompanied by a college transcript.

7.(a) A statement of appraisal of the applicant in terms of potential for growth, character, leadership capacity, and career interest from three evaluators is required; at least one should be from a faculty member. The statements of appraisal must be returned directly to MCIB/CPG by each evaluator.

(b) Applicants must ensure that MCIB/CPG has received these appraisals before application deadline.

8.Gold Award scholarship will provide up to a maximum of $2500.00 per year, depending on available Fund value and applicant qualifications and need.

Application Requirements Silver Award:

2.Applicant must be pursuing a Bachelors or Associates degree in the field of Civil Engineering, Geological Engineering, Construction Engineering, Construction Management, Construction Technology or Engineering Technology and must have completed at least 24 credit hours towards their major degree.

3.Applicant must not be a son, daughter, grandson, granddaughter, niece or nephew of an Advisory Committee member.

4.Part-time student applicants will be limited to sophomore class status or above. The scholarship award to part-time students will be commensurate with the costs.

5.The application must be typewritten. Responses to questions on the application must be answered on the form, with the exception of the essay question, which may be typed on a separate sheet and attached to the application. The application must be accompanied by a college transcript.

6.(a) A statement of appraisal of the applicant in terms of potential for growth, character, leadership capacity, and career interest from three evaluators is required; at least one should be from a faculty member. The statements of appraisal must be returned directly to MCIB/CPG by each evaluator.

(b) Applicants must ensure that MCIB/CPG has received these appraisals before application deadline.

7.Silver Award scholarship will provide up to a maximum of $1500.00 per year, depending on available Fund value and applicant qualifications and need.

PERSONAL DATA

1. Name:

(Last)(First)(Middle)

2. Permanent Home Address:3. Current Address:

4. Permanent Phone: 5. Current Phone:

6. Date of Birth: //7. Social Security Number:

8. Parents’ Names:

9. Parents' Address (if different from yours):

10. Marital Status: Single Married

11. Scholarship Award Level Applied for: ______(Gold or Silver)

FINANCIAL DATA

Annual Family Gross Income:

Total Family Members (include yourself): Number of family members in college (include yourself)

Anticipated College Expenses:Your Family/Yourself can contribute:

Tuition (full year)$Tuition (Full year)$

Books$ Books$

Room & Board$ Room & Board$

Other (explain)$ Other (explain)$

TotalCollege Expenses $ Total Family Contribution$

You are receiving financial aid from the following:

A. Present school yearB. Expected next year (Scholarship)

Scholarships $ Scholarships :$

Grants$ Grants$

Loans$ Loans$

Work Study$ Work Study$

Total Financial Aid $ $

Summary:

TotalCollege Expenses$

Less: Total Family Contribution$

Total Financial Aid$

Total Funds Needed for College in ____ $

Name:

ACADEMIC DATA

High School Attended: Name:

Address:

College or University Attending: Name:

Address:

Student Status: Graduate______Senior ______Junior ______Sophomore ______

Enrollment Status: Full Time ______Part Time ______Cumulative GPA ______(attach transcript)

Expected Graduation Date: (month & year): ______

Fields of Study:Major:______

Minor:______

Gold Level Award ONLY :List concrete and concrete design courses taken and date completed or to be completed.

Silver Level Award ONLY :List relevant degree major courses taken and date completed or to be completed.

List professional organizations and positions held.

List other organizations and positions held.

Essay

(One to two pages, typed and double-spaced, with name at top of each page. Attach a separate, typed sheet here.)

This essay should discuss, but is not limited to, the use of the scholarship, your interest in concrete and concrete design, construction, or engineering/construction technology, educational goals, financial need, and future plans and goals upon graduation.

References

List the names of three persons whom you have requested appraisals and recommendations to be mailed to MCIB/CPG. In the space provided, list the name, employer, title, address and phone number.

I certify that the information contained in this application is true and that I have answered all questions to the best of my ability.

Further, I agree that I will notify the MCIB/CPG immediately when my educational program is interrupted or changed in any manner that might jeopardize the interest of the scholarship award.

I further agree that I will accept the scholarship only as long as I pursue, successfully, the curriculum program for which the award is made, and that any funds remaining at the termination of my enrollment will be returned to the MCIB Educational Fund.

Signature:

Date:

Return completed application and required information to:

MCIB/CPG. Attn: Cindy Allen

15700 College Blvd., Suite 103

Lenexa, KS 66219