2022 Education Fund Award Application If you have not already reviewed the 2022 Eligibility & Instructions please do so before beginning your application submission.Part 1 - Personal Information* NEW APPLICANT REAPPLICANT BIRTH DATE* MM slash DD slash YYYY APPLICANT NAME* First Last ADDRESS* STREET APT./FL. CITY AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific STATE ZIP Residency in NYC is a requirement. HOME PHONEWORK PHONECELL PHONE*EMAIL* SOCIAL SECURITY NO. (LAST 4 DIGITS ONLY)*Please enter a number from 0000 to 9999.Part 2 - Education InformationCOLLEGE CURRENTLY ATTENDING* MAJOR OR INTENDED MAJOR* CURRENT CUMULATIVE GPA:*CAREER GOAL* Dates Attending Current Institution: START DATE:* MM slash DD slash YYYY ANTICIPATED GRADUATION DATE:* MM slash DD slash YYYY CREDITS COMPLETED (at time of application):*CREDITS REMAINING (to complete Associate's/Bachelor's):*Note: If you are graduating from an Associates degree program before June of 2022, you will be asked to provide proof of application or enrollment in a Bachelors degree program.*High School NameGPAYear BeganYear EndedYear Graduated (if applicable) *Post Secondary Institution NameGPAYear BeganYear EndedYear Graduated (if applicable)Type of Degree Program/Certificate Part 3 - Employment Status/IncomeEmployment (Past 5 years)Name and Address of EmployerYour Title and a Brief Description of Your ResponsibilitiesFull-Time or Part-Time (if part-time, please indicate number of hours/week)Dates From - To (mm/dd/yyyy - mm/dd/yyyy) List any wage earners, other than yourself, including their occupation.(Indicate if none)First NameLast NameOccupationRelationship Part 4 - Community ServiceNot 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 OrganizationDescription of your involvement and how it relates to your career leadership potentialAmount of time per week you are/were involvedDates From - To (mm/dd/yyyy - mm/dd/yyyy) Part 5 - Letters of ReferencePROVIDE TWO LETTERS FOR REFERENCE. These should be written by faculty or administrators at your college familiar with your academic work and ideally, your family history, academic history, and career goals. Past accomplishments and comments about your leadership potential should be stressed. Please ask these persons to email their letters of references to application@womensforumny.org. As we receive many qualified applications, their ability to write convincingly and substantively of your promise will carry significant weight.Academic Reference*NameTitlePhoneInstitutionEmailAcademic Reference*NameTitlePhoneInstitutionEmailPart 6 - Personal EssaysEssay #1 - Career Goals and Motivation Please describe your career goals and motivation for seeking this Award. If relevant, please include any meaningful leadership experience or involvement in community service, art, athletics, business, science, or other extracurricular activities. Copy & paste or type below*Essay #2 - Personal History Please describe your personal history including challenges or obstacles overcome in pursuing an education. Please also discuss your academic record as an indication of noteworthy leadership promise. (Financial need will be addressed separately below.)Copy & paste or type below*Part 7 - Financial InformationAll Dependents, including ages:(indicate if none)First NameLast NameAgeRelationship Please help us understand your current and anticipated financial situation, including how receiving this award will impact your ability to achieve your career goals. Please include details on your earned income, any other awards, family support, Federal assistance, etc. Copy & paste or type below*Part 8 - Resume (optional)File UploadAccepted file types: pdf, doc, docx, Max. file size: 100 MB.Part 9 - TranscriptAn official transcript must be postmarked or emailed by Mar. 1, 2022 Women's Forum of New York (attn: Education Fund Application) 59 East 54th Street, Rm. 81 New York, NY 10022 An official transcript includes a college seal from the registrar. If your college uses a secure automated transcript sharing system, direct it to application@womensforumny.org.* I certify that the information I have provided in this application is true and accurate to the best of my knowledge and that false statements will result in disqualification. Part 10 - Where did you hear about us?* School Newsletter Financial Aid Faculty/In-Class Previous Awardee Other Please specify with a specific name/email if possible: Applicants will be notified of results no later than June 30, 2022.
