Application must be received no later than 5 P.M., May 1, 2015

Scholarship Fund APPLICATION

ARIZONA Chapter of the

Chartered Property Casualty Underwriters (CPCU) Society

Award Semester/Year: Fall 2015Award Amount: $1,000

Eligible students will each receive a $ 1,000 scholarship award to be applied to tuition, textbooks, and other school-related fees at a college (4YR or 2 YR) in ARIZONA.

Applicant must meet the following eligibility criteria:

Must be pursuing one of the following degree programs with an interest in the insurance industry: (CHECK ONE)

  • Business or business related
  • Finance, Accounting, or Economics
  • Mathematics, Statistics, Analytics, or Actuarial
  • Insurance, Risk Management, or Law
  • Computer Information systems or Data Mining/Modeling

Must be a full time (12 credits minimum) student during the Fall 2015 semester (Please submit current or future schedule with application.)

Must be enrolled in at least one 3-credit degree-related course for Fall 2015 (waived for high school applicants)

Must have a minimum 2.5 GPA for the prior full-time semester; or, for last year in high school. The GPA report must be signed by the school’s registrar. (Please submit with application.)

Must submit a brief essay describing educational and career plans and outlining why youare deserving of this scholarship award. Essay must be prepared using word processing software and printed, double-spaced, of 500 words or more, and attached to this application form. Please include any insurance affiliations including internships, part-time or full-time positions in the insurance field, career interests related to insurance, etc.

Must submit a letter of recommendation from a faculty member, either from high school or college.

Student Name ______

Student ID/ Social Security # ______

Street Address ______

City/State/Zip ______

Home Phone # ______Other Phone # ______

E-Mail ______

Name and address of educational institution you will attend in the Fall of 2015. The scholarship will be paid directly to the college for your account: ______

______

Applications and all supporting documents must be e-mailed to the following e-mail address no later than May 1, 2015at 5:00 P.M.:

Diane Scheidt at

Phone: (480)265-8870

I understand that all information provided in this application will remain confidential.

I certify that the above information is accurate and correct. I authorize ______

______to release academic and other information as required for this scholarship.

______

Student signature Date

Scholarships are funded by the ArizonaCPCU Society Chapter