SENATOR BOBBY ZIRKIN

JERRY E. MILLER/ JOSEPH BERMAN MEMORIAL SCHOLARSHIP

APPLICATION

This application is for undergraduate and post graduate students.

Please Return to Our Office no later than April 30, 2017 to: Senator Bobby A. Zirkin

2 East Miller Senate Office Building

11 Bladen Street

Annapolis, MD 21401 or

Email:

(Please print clearly)

Student’s Full Name: ______

Date of Birth: ______

Street Address: ______

City, State, Zip: ______

Home Phone Number: ______Cell Phone Number: ______

Email Address: ______

High School: ______Graduation Date: ______

GPA: ______Extra Curricular Activities and/or Community Service: ______

______

Name of College/University Currently Attending, if applicable ______

or Will Attend 2017: ______

Enrollment: Full-time___Part-Time____

A FAFSA FORM MUST BE COMPLETED FOR THE CURRENT SCHOOL YEARBEFORE YOU CANBE CONSIDERED FOR A SENATORIAL SCHOLARSHIP

Name of Parent or Guardian: ______

I have reviewed this application and verify that the submitted information is complete and accurate.

______

Signature of StudentDate

______

Signature of Parent or Guardian (if applicable) Date

PLEASE NOTE: SENATORIAL SCHOLARSHIPS ARE GIVEN FOR MARYLAND STATE SCHOOLS UNLESS ENROLLED IN AN ACADEMIC PROGRAM THAT MARYLAND DOES NOT OFFER.

Dear Scholarship Applicant,

Please find the application for the 2017 Jerry Miller / Joseph Berman Memorial Scholarship below. Jerry Miller taught Business Education at Pikesville High School for 33 years and was loved and respected by generations of students. He died of a heart attack in 2003 at the young age of 56. Joe Berman was a marine and a veteran of the Gulf War and a dear friend of Senator Zirkin.

To be eligible, by law, a prospective student must be a District 11 resident pursuing an undergraduate, graduate, or post-graduate degree in the state of Maryland. If you would like consideration for an award, please send a completed application to Senator Zirkin’s office no later than April 30, 2017. Email is the preferred method of receiving applications.

Acomplete application includes:

1. The form below filled out in its entirety

2. A 1-2 page personal statement in either word or pdf format

3. You may also include any other supporting materials (transcripts, resumes, etc.)

You must also submit your FAFSA application before March 1. You may apply for the FAFSA on-line at

My Scholarship Committee will review all applications and make recommendations for awards based on your academic achievement, and the standards of financial need suggested by the Maryland Higher Education Commission.

Maryland generally limits its Senatorial Scholarships to those students attending school in the State of Maryland. However, applicants who choose to attend school out of state may still meet the criteria for eligibility for a Senatorial Scholarship if they enroll in an academic program that Maryland does not offer. If you feel your academic program may qualify, please contact the Maryland Higher Education Commission as soon as possible to have your major certified as “unique.”

If you receive a scholarship, the Maryland Higher Education Commission, as well as my office, will notify you. I look forward to receiving your completed application byApril 30, 2017. Scholarship recipients will be made aware of their award by late May. Should you have any questions or need additional information, please do not hesitate to contact my office at (410) 841-3131.

Email completed applications to: or

Mail completed applications to: Senator Bobby Zirkin

2 East Miller Senate Office Building

11 Bladen Street, Annapolis, MD 21401