High School Scholarship Application

The Board of the Western New York Safety Conference is continuing our Annual Scholarship Program. We will be awarding four $1,500 scholarships to selected qualified high school seniors.

Applicants are required to be:

• At least high school senior attending college in the fall of 2019
• A resident of Western New York

Applicants are required to submit by January 28, 2019:

• A completed application
• A typed essay of at least 400-500 words
• Certification of grade point average
• At least one letter of recommendation

It should be noted that

• Financial need will be taken into consideration when scholarship winners
• The essay should reflect your understanding of the importance of occupational safety & health.What the far-reaching impact laws and standards protecting workers have had on society and/or your chosen career path.
• What the far-reaching impact laws and standards protecting workers have had on society and/or your chosen career path

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Fill out the Scholarship Form Below

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Scholarship Application Form

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Name *

First

Last *

Last

Social Security Number (Last 4 Digits Only) *

Home Address

Street *

City *

State *

Zip *

Phone Number *

Email *

High School or College Record:

School

Major

Minor

Extra Curricular Activities

Class Level

Anticipated Date of Graduation

Cumulative Average as of the end of this Fall Semester

SAT Verbal Score

SAT Math Score

SAT Critical Writing Score

Parents Combined Annual Adjusted Gross Income Ad (last Adjusted Gross Income / Federal 1040, 2016 Tax Return) Financial need will be taken into consideration.

Applicant's Essay: *

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Please prepare a concise essay (400-500 words) regarding your background, including educational and career goals. Your essay should reflect your understanding of the importance of occupational safety & health. What the far-reaching impact laws and standards protecting workers have had on society and/or your chosen career path.

Recommendation Letter

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Certification of Grade Point Average

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I certify that to the best of my knowledge all information and statements are correct and accurate. I further understand that this application, the essay, references, a certification of my cumulative grade point average and enrollment status may be given to the scholarship committee members of the donor organization(s) for their review *