APPLICATION HAROLD MINCEY SCHOLARSHIP FUND SECTION A: (TO BE COMPLETED ...
APPLICATION HAROLD MINCEY SCHOLARSHIP FUND SECTION A: (TO BE COMPLETED BY APPLICANT)
Name________________________________________________________ Sex_______
(Last)
(First)
(Middle)
(F/M)
Address_________________________________________________________________
__________________________________________________________________
Social Security No.______________________ Home Phone (_____)________________
CWA Member name________________________________Occupation______________
CWA Member address_____________________________________________________
_____________________________________________________ SECTION B: (TO BE COMPLETED BY CWA LOCAL UNION OFFICIAL)
This is to certify that _________________________________________________ is: (Name of scholarship applicant)
_____ A member of CWA Local________ located in ____________________________ (City)
_____ The child or dependent (spouse not eligible) of a member of CWA.
_____ The child of a deceased member of CWA.
SECTION C: (TO BE COMPLETED BY LOCAL PRESIDENT OR SECRETARY)
Signature__________________________ Title_________________ Local #__________
NOTE TO ALL APPLICANTS A son, daughter or dependent (spouse not eligible) must live in the same household or have at least 50% of their support provided by a CWA member. Applications must be submitted between January 1 and March 31 of each year to be eligible for the drawing held in May of each year. All applications must be accompanied by a 500 word essay on "Unionism".
Mail application to: CWA/ Harold Mincey Scholarship Fund 3516 Covington Highway Decatur, GA 30032
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