Tate-Chesmore Employee Scholarship Application
Residential Programs and Services employees provide services to thousands of students each year. The Tate-Chesmore Employee Scholarship honors two former employees who exemplify the values of hard work and dedication to service that this scholarship will recognize. Wendell Tate worked in the Halls of Residence for many years in positions of increasing levels of responsibility and retired in 1991 as Maintenance Supervisor; Ruth Chesmore worked at Indiana University for several decades in positions of increasing levels of responsibility and retired in 1988 as Associate Director of Foods for the Halls of Residence.
To recognize their contributions and those of countless other dedicated employees from the Halls of Residence and Residence Life, RPS offers a competitive scholarship to its full-time service, support, and non-exempt employees, their spouses, registered domestic partners, or dependent* children. The scholarship, supported by gifts to the Greenleaf/Nelson Fund, includes a $500 credit to the general bursar account and, if needed, a $500 credit for RPS housing or meal plan.
Qualifications:
· Eligible employees include current full-time service staff, support staff, and non-exempt staff, retirees from those positions, or their spouses/partners or dependent children
· Must be in good standing with the University and/or department of employment
· Must show proof of acceptance to the University if not currently enrolled
· Must be pursuing an undergraduate degree
*Dependents definition: a child, a stepchild, a child whose legal guardian is an eligible employee/spouse/partner, or a child of a deceased employee/spouse/partner eligible at time of death, and who fit the following criteria:
o Is 23 years of age or under
o Is unmarried
o Meets the IRS support test as a dependent of the employee, spouse, or partner
Scholarship applications are due by Friday, February 26, 2016 to . Please provide thorough answers to allow the committee to fairly consider your application.
The Tate Chesmore Employee Scholarship
Application for Award
Please type all responses.
Date of Application
Personal Information
Name
Student ID Number
Current Address
Next Year Address
Phone
IU email address
Academic Information
Class Standing
Anticipated Graduation Date
GPA
Major or Field of Study
Any Minors, Concentrations, or Special Areas of Study
Academic Honors you have received
Career Objectives (Include plans for Graduate School, Extended Travel, etc..)
Status
Are you a current full-time employee or retiree?
Spouse or partner of employee or retiree?
Dependent of employee or retiree?
Name of employee or retiree:
Currently Enrolled at IU:
If not, send a copy of IU Admissions Acceptance Letter with this application.
Please tell us how this award will assist you in achieving your academic goals and your career goals.
How have you embodied the tenants of this scholarship?
Certification: I certify that the foregoing information is accurate.
Grade and Transcript Release:
I hereby consent to the release of all academic and educational records to the selection committee, for the purpose of allowing the committee to use and review those records in connection with its consideration of my application for a scholarship.
Printed Name
Signature______Date______