North Carolina CCIM - CI 101

Michael J. Barr, CAE, RCE Named Endowed Scholarship

Scholarship covers up to $500 in Class Cost

Must be used on a North Carolina CI Class in the year scholarship was issued.

Check will be dispersed upon completion of the class.

Named Endowed Scholarship Program Application

(To be completed by scholarship applicant and submitted to chapter)

Date Submitted:______Chapter: ______

Applicant's Name: ______

Company: ______

Work Address: ______

City/State/Zip______

Work Phone Number: ______Email: ______

Home Address: ______

City/State/Zip______

How many years have you been involved in the real estate industry? ______

Have you taken CI Intro? Yes No

Do you plan to obtain the CCIM designation? Yes No

What other CCIM CI Classes have you taken? (Please Circle) CI 101 CI 102 CI 103 CI 104

Please include the following with this application:

1.  Current Resume

2.  Three professional references

3.  Typed letter which includes answers to the following questions:

§  Why do you want to become a CCIM?

§  What are your contributing achievements to your company and/or industry?

§  What are your career goals?

§  Would you take the course even if the scholarship were not available and why?

4.  Media Contacts

References

Provide three professional references.

Name: ______Position/Relationship: ______

Address: ______

Phone Number: ______

Length of time you have known this person: ______

Name: ______Position/Relationship: ______

Address: ______

Phone Number: ______

Length of time you have known this person: ______

Name: ______Position/Relationship: ______

Address: ______

Phone Number: ______

Length of time you have known this person: ______

By submitting this application, I agree that in the event I am chosen to receive a scholarship, the CCIM Education Foundation and/or CCIM Institute and Chapters may use my name, likeness and/or profile in printed and electronic promotional materials.

By:______

Applicant Date

By:______

Chapter President Date

Submission:

Return completed application to the North Carolina Chapter of CCIM

NC-CCIM

23 Oak Branch Drive

Greensboro, NC 27407

Phone: 336-854-5868 Fax: 336-292-5416 Email: