SCHOLARSHIP APPLICATION 2017

Please complete this form. Typed or printed forms are acceptable.

Applicant Information

First Name / MI / Last Name
Home Address / Apt/Suite
City / State / Zip Code
Email Address / Phone Number

EDUCATION INFORMATION

Type of School / [ ] 2-Year College / [ ] 4-Year College / [ ] Graduate School / [ ] Other
Institution Name / Address
City, State / Admissions Office Phone
Major or
Field of Study / GPA / Grad
Date

ACTIVITIES & AWARDS

Honors & Awards
Extracurricular Activities
Jobs
Volunteer Work

Terms & Conditions

By applying for the Creative Safety Supply scholarship, you agree to these terms:

  • You must be a citizen of the United States to be considered for the scholarship.
  • Awards will be sent directly to the educational institution the student attends.
  • Applicants must be currently enrolled in the accredited educational institution of their choice for the upcoming semester.
  • Applicants must be full-time students (i.e. they must be enrolled in enough courses to be considered full time by their educational institution).
  • Creative Safety Supply may use any work submitted by scholarship winners as part of the competition for any purpose deemed necessary by the company.
  • Winners may be required to submit a current photo and publicity release granting Creative Safety Supply permission to use their photo for marketing purposes and on creativesafetysupply.com.
  • Scholarship winners will be notified using the contact information provided in their applications. If we are unable to reach the winner within 30 days, he/she will forfeit the scholarship and Creative Safety Supply reserves the right to select a new winner.
  • The scholarship is not renewable; winners may not reapply.
  • Creative Safety Supply reserves the right to change the scholarship program at any time, including deadlines, requirements, scholarship amount, and other parts of the program. We also reserve the right to cancel the program for any reason.

I have read and understand the conditions of the Creative Safety Supply scholarship and affirm that the contents of this application are my own work. I affirm the information contained herein is true and accurate to the best of my knowledge.

Full Name / Date

Send your completed application form, along with your essay responses and a copy of your transcripts, to .

About Creative Safety Supply

Creative Safety Supply is a retailer of safety and lean manufacturing products for the workplace. The Beaverton, Oregon-based company helps businesses comply with floor marking, labeling, and safety requirements and create spaces that are easy to navigate. The company’s products help safety and facility managers take control of marking their workplaces with products that are simple to use and last a long time. Creative Safety Supply believes everyone plays an important role in safety and seeks to help people find creative solutions for their workplace safety problems.