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2014 Education Award Application

Before you begin, click here to determine eligibility and to read directions.

BIRTH DATE (ex. mm/dd/yyyy)
NAME:
  (Last) (First) (Middle)
ADDRESS: Apt./Fl.
CITY: STATE: ZIP:
PHONE: (Home) (Work) (Cell)
EMAIL:
SOCIAL SECURITY NO. (LAST 4 DIGITS ONLY) 
COLLEGE CURRENTLY ATTENDING:
MAJOR
IF AT A COMMUNITY COLLEGE, WHAT IS YOUR INTENDED BACHELORS DEGREE MAJOR?
CAREER GOAL
DATES ATTENDING CURRENT INSTITUTION: FROM  (ex. mm/yyyy)    TO: (ex. mm/yyyy)
ANTICIPATED DATE OF GRADUATION FROM YOUR CURRENT INSTITUTION (ex. mm/yyyy)
PREVIOUS EDUCATION HISTORY:
High School Year of Graduation (ex. 2013) GED Year Received GED (ex. 2013)
List the name of any college you have attended Year Began Year Ended Year Graduated Type of Degree Program
ALL DEPENDENTS, INCLUDING AGES: (indicate if none)
LIST ANY WAGE EARNERS, OTHER THAN YOURSELF, INCLUDING THEIR OCCUPATION. (Indicate if none)

EMPLOYMENT RECORDS (Last 4-5 years). Begin with the most recent:

Name and Address of Employer
Your Title and a Brief Description of Your Responsibilities
Full-Time or
Part-Time (if part-time, please indicate number of hours/week)
Dates
From - To

(mm/yyyy - mm/yyyy)

COMMUNITY SERVICE: Not all applicants will have been able to be involved in community service activities, but if you have been involved as a volunteer in community service activities in the past 4-5 years, please check and list below.

 No, I have not had the opportunity, or time, to volunteer.      

 Yes, If yes, please list below.

Name and Address of Organization
Description of your involvement and how it relates to your career leadership potential
Amt of time per week you are/were involved
Dates
From - To

(mm/yyyy - mm/yyyy)

REFERENCES
SUBMIT NAMES, ADDRESSES, PHONE & EMAIL OF THREE PERSONS WHO KNOW YOU WELL. . (No Family Members)

Past accomplishments and comments about your leadership potential should be stressed.
Two of the three references MUST be from faculty or administrators at your college familiar with your academic work.

Please ask these three persons to mail their references in a sealed envelope, with their signature on the back of the envelope. As we receive many qualified applications, the role, position, and stature of your references and their ability to write convincingly and substantively of your promise will carry significant weight.

Letters of Reference must be postmarked by December 1, 2013 and mailed by US Mail to the Women's Forum at:

Women's Forum Inc.
55 West 39th Street, Suite 12N
New York, NY 10018

REFERENCES

1.
Name 
Phone 

Address  

Email
 
2.
Name  
Phone 
Address  

Email
 
3.
Name  
Phone  
  Address  

Email


PERSONAL ESSAY
SUBMIT TWO PERSONAL ESSAYS of no more than 500 words each.
One essay should address your personal history and one should address your career goals and motivation. Both topics are described below:

  1. Personal history, challenges, obstacles, other than financial, that you have overcome while pursuing an education, and general academic record as an indication of noteworthy leadership promise. (Financial need will be addressed separately.)
  2. Copy and paste your essay in the text field provided below:


  3. Career goals and motivation. If appropriate, any meaningful involvement, as well as any leadership experience, in community service, art, athletics, business, science, or other extracurricular activities
  4. Copy and paste your essay in the text field provided below:


FINANCIAL STATEMENT
SUBMIT A SEPARATE FINANCIAL STATEMENT
of no more than 100 words.

  1. Describe your present and anticipated financial situation. Please state how receiving this Award will help and how you would wish to use the funds from the Award.
  2. Financial need, as well as challenges surmounted and leadership potential, are considered by the Women's Forum Education Fund Award Committee.
  3. The Education Fund of the Women's Forum is required to issue a 1099 for each of the two installments of the award, one in 2014, and one in 2015.
  4. Copy and paste your statement in the text field provided below:

TRANSCRIPT
Mail an official transcript to the Women's Forum, postmarked by December 1, 2013. An official transcript
includes a college seal from the registrar.

The Women's Forum through these awards is committed to fostering the development of
women who evidence strong leadership promise in their chosen fields
.

I have read the Information Sheet (click here to view Information Sheet).

DEADLINE: APPLICATION, TRANSCRIPT AND 3 LETTERS OF REFERENCE
MUST BE POSTMARKED BY DECEMBER 1, 2013.

Questions? Contact info@womensforumny.org or 212-447-9107

 


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