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Insurance Scholarship Application
Ruth Hankes
2019-09-04T12:34:37-06:00
Insurance Scholarship Application
The deadline is one week prior to the start of your Insurance Class. This is a $500 scholarship. Eligibility is one per student. All scholarships are reported to the College Financial Aid Office. In the event that you are over-awarded, your scholarship may be applied to your outstanding loans. If you have any questions please contact the Foundation at foundation@madisoncollege.edu or call 608-246-6441.
PERSONAL INFORMATION
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Madison College Student ID#
*
Madison College Email Address
*
Madison College Campus
*
Truax
Commercial
West
Fort Atkinson
Portage
Reedsburg
Watertown
South
Please check any that apply (Optional, this information will not affect your eligibility)
African American
Asian or Pacific Islander
Caucasian
Hispanic
Hmong
Native American
Veteran
Single Parent
EDUCATION
List high school, other colleges/universities you attended (include School, Dates and Diploma/Degree)
List high school, other colleges/universities you attended (include School, Dates and Diploma/Degree)
List high school, other colleges/universities you attended (include School, Dates and Diploma/Degree)
EMPLOYMENT
Please list the name of your employer, dates employed, position and hours per week
Please list the name of your employer, dates employed, position and hours per week
Please list the name of your employer, dates employed, position and hours per week
ADDITIONAL REQUIREMENTS SPECIFIC TO THIS SCHOLARSHIP
Please check all that apply
*
I am not receiving employer reimbursement for this course(s).
I am currently enrolled in Insurance course(s)
SHORT ESSAYS
Type a brief essay in response to the topics below.
Which Insurance course(s) are you interested in and why?
*
Insurance is designed to provide "peace of mind"; to provide a financial resource should you suffer a loss of property, life, or health or unintentionally cause injury to another or damage their property. If you could insure anything of value to you (and you can) what would you insure and why is it valuable to you?
*
What are your goals/plans after you complete your Madison College degree?
*
Describe your involvement in professional, community and/or extracurricular activities. List the organizations and activities. Include any leadership positions that you have held. If unable to participate, provide a brief explanation.
*
Additional Consideration – describe any other recent major life changes that should be considered.
*
I authorize access and release to the scholarship selection committee all relevant information concerning financial resources I may receive, as well as high school and/or college academic records. This information will be used for evaluating the application and not published or shared with others. I also authorize the Foundation to share information from this application with scholarship donors. To ensure a fair and objective review process, it is the policy of the Foundation not to comment on the deliberation of the awards committee. Thus the Foundation is unable to provide written or oral evaluations to applicants after decisions are made. No provisions exist for reconsideration of awards after scholarships are announced. All applications and supporting materials become the property of the Madison Area Technical College Foundation and, as such, will not be returned. I certify that the information I have supplied on this application is complete and accurate to the best of my knowledge, and I understand that knowingly submitting inaccurate or false information will result in the denial or loss of any scholarship offers or awards.
*
By Signing this application, I agree to all terms and conditions stipulated herein.
Applicant’s Signature (Type your full name)*
*
Date
*
