AFFILIATION
League affiliated?
Yes
No
Which league?

What year of CUNA Management school are you entering?
1st year
2nd year
3rd year

SCHOLARSHIP CATEGORIES
Please check all that apply:
Less than $6 million in assets
Community development CUs
Education/school CUs

First Name:

Last Name:

Present CU position:

Full-time
Part-time
Volunteer
If you are a volunteer, what is your full-time occupation?


Full CU name

CU address

City

State

Zip

CU phone

CU Fax

Your email address:


Will you receive tuition or other financial assistance from your credit union?
Tuition assistance
Yes
If yes, how much?

No

Travel Expenses
Yes
If yes, how much?

No

There may be other scholarship dollars available. We encourage you to apply for a scholarship with all available resources; from your league, state chapter, a sponsor, and any other sources.

Have you applied for a scholarship with other sources?
Yes

Will you receive other scholarship monies through one or more of the following sources?

League
Yes
No
Amount Requested
Date of Decision

Chapter
Yes
No
Amount Requested
Date of Decision

Sponsor
Yes
No
Amount Requested
Date of Decision

Other
Yes
No
Amount Requested
Date of Decision
Name "other" source:



What are the total assets of your CU?

Number of CU members


Will you lose wages while attending CMS?
Yes
No
If yes, how many days?

Will you be using vacation time to attend CMS?
Yes
No
If yes, how many days?

Scholarship funds requested at this time:
$
(Scholarship monies can only be applied to tuition expenses, not for travel expenses.)

Briefly tell us why a scholarship is important to you. How would you use this scholarship and educational experience to benefit your members and credit union? Your career goals? (Fax additional pages if necessary.)


Please tell how you found out about our scholarship program:


Second and third year students: Have you received funding in the past?
Yes
No
If yes, from what source?


Date:

PLEASE NOTE
We suggest you retain a copy of the application for your records.
Scholarships are awarded on the basis of need and for tuition expenses only (not for travel expenses).

DON'T FORGET
Application Deadline: April 1, 2008 - applications received after that time will not be considered.