Human Resources - Elon University



RTAC Scholarship application

TYPE OR PRINT ALL INFORMATION EXCEPT SIGNATURES

Completeness and neatness ensure your application will be reviewed properly. Application postmark deadline October 23, 2015

APPLICANT Last Name First Middle Initial

DATA Home

Mailing Address Apartment #

City State Zip Code

Telephone ( ) E-mail Address

Name of Law School you attend

Date of Birth: Month Day Year

Please indicate your status. (For statistical purposes only) ( Male ( Female

( American Indian /Alaska Native ( Black/African American ( Multi-Racial ( White/Caucasian

( Asian ( Hispanic/Latino ( Native Hawaiian/Pacific Islander

Name of post-secondary schools you attended and degrees received.

Use official school names. Do not use abbreviations for school names.

School: City State

Major or course of study: GPA: Date of graduation: Month Year

Degree: ( Bachelor ( Masters ( Other

School: City State

Major or course of study: GPA: Date of graduation: Month Year

Degree: ( Bachelor ( Masters ( Other

FINANCIAL Please provide any information you would like the RTAC Scholarship Selection Committee to know concerning your financial needs.

NEED

GOALS Please describe how you plan to use your legal education to pursue your career objectives and long-term goals.

AND

ASPIRATIONS

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Note: You may append a copy of your resume, but doing so does not replace any part of this application. If space provided in any section is inadequate, you may continue on additional sheets. Attachments must follow the same format. DO NOT repeat information already reported on the application form. Your name and address should be included on all attachments.

WORK Describe your work experience during the past four years. Indicate dates of employment for each job and approximate number of hours

EXPERIENCE worked per week. List approximate amounts earned at each job.

|Employer/Position |From - Mo/Yr |To - Mo/Yr |Hours per week |Amount Earned |

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ACTIVITIES, List all school activities in which you have participated during the past four years (e.g., student government, music, sports, etc.). List all

AWARDS AND community activities in which you have participated without pay during the past four years (e.g., Boy/Girl Scouts, hospital volunteer, Special

HONORS Olympics). Note all special awards, honors and offices held.

|Activity |No. of |Special Awards, |Offices Held |

| |Years |Honors | |

| |Partic. | | |

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Please describe how and when any unusual family or personal circumstances have affected your achievement in school, work

experience, or your participation in school and community activities.

Two appraisals must be submitted in the format provided below. Your application will not be evaluated until all appraisals have been received. Appraisals should be completed by a law school advisor or instructor, or a work supervisor who knows you well. All appraisals must be postmarked by October 23, 2015.

TRANSCRIPT An official transcript of grades must be sent with this application or under separate cover postmarked by October 23, 2015.

INFORMATION On-line transcripts and grade reports are not acceptable.

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The Applicant is responsible for submitting all materials to RTAC on time. Incomplete applications will not be evaluated. This application becomes complete and valid only when RTAC has received all of the following materials:

( Completed Application

( Two Applicant Appraisals

( Current Complete Transcript(s) of Grades

On-line transcripts are not acceptable.

Postmark deadline October 23, 2015

PERSONAL

INFORMATION Personal information supplied by scholarship applicants will be used by RTAC to assess your qualifications to receive a RTAC scholarship for an approved law school program. We do not sell, trade, or rent your personal information to others. We may share your personal information with all members of RTAC’s Board of Directors and Selection Committee so they may use such information as a part of their evaluation of your application or otherwise contact you. RTAC may also release your personal information when we believe, in good faith, that such release is reasonably necessary to (i) comply with law, (ii) confirm the assertions contained in your application, or (iii) protect the rights, property or safety of RTAC, its members, or others.

By applying for the RTAC scholarship, you consent to the collection and use of your personal information by RTAC for the purposes described above, and you authorize RTAC to disclose any of all of such information to confirm the assertions contained in your application. If you have questions about RTAC’s practices with respect to your personal information, please contact Brian Klemm at the above address or by email at brianwklemm@.

CERTIFICATION RTAC has the sole responsibility for selecting scholarship recipients based on criteria established by RTAC. This application becomes the property of RTAC. (It is recommended that you keep a copy for your files.)

I acknowledge decisions of RTAC are final. I certify that the information provided in this application is complete and accurate to the best of my knowledge. If requested, I agree to provide proof of information I have given on this form. Falsification of information may result in termination of any scholarship granted.

Applicant’s Signature Date

APPRAISAL

APPLICANT Last Name First Middle Initial

DATA

Address Apartment #

City State Zip Code

To the Appraiser: You have been asked to provide information in support of the above named individual’s application for a scholarship offered by the Research Triangle Area Chapter of the Association of Corporate Counsel. Please complete this form and return it directly to the Chapter at the address indicated below, postmarked no later than October 23, 2015.

|The applicant’s choice to study law is |( extremely |( very appropriate |( moderately |( inappropriate |

| |appropriate | |appropriate | |

|The applicant’s achievements reflect his/her ability |( extremely well |( very well |( moderately well |( not well |

|The applicant’s ability to set realistic and attainable goals is |( excellent |( good |( fair |( poor |

|The applicant’s commitment to the study of law is |( excellent |( good |( fair |( poor |

|The applicant is able to seek, find, and use learning resources |( extremely well |( very well |( moderately well |( not well |

|The applicant demonstrates curiosity and initiative |( extremely well |( very well |( moderately well |( not well |

|The applicant demonstrates good problem-solving skills, follows | | | | |

|through, and completes tasks |( extremely well |( very well |( moderately well |( not well |

|The applicant’s respect for self and others is |( excellent |( good |( fair |( poor |

Comments:

Appraiser’s Name Title Telephone ( )

Signature Organization Date

Please return completed Appraisal to:

RTAC Scholarship Program

c/o Brian Klemm

204 Loch Ryan Way

Cary, NC 27513

APPRAISAL

APPLICANT Last Name First Middle Initial

DATA

Address Apartment #

City State Zip Code

To the Appraiser: You have been asked to provide information in support of the above named individual’s application for a scholarship offered by the Research Triangle Area Chapter of the Association of Corporate Counsel. Please complete this form and return it directly to the Chapter at the address indicated below, postmarked no later than October 23, 2015.

|The applicant’s choice to study law is |( extremely |( very appropriate |( moderately |( inappropriate |

| |appropriate | |appropriate | |

|The applicant’s achievements reflect his/her ability |( extremely well |( very well |( moderately well |( not well |

|The applicant’s ability to set realistic and attainable goals is |( excellent |( good |( fair |( poor |

|The applicant’s commitment to the study of law is |( excellent |( good |( fair |( poor |

|The applicant is able to seek, find, and use learning resources |( extremely well |( very well |( moderately well |( not well |

|The applicant demonstrates curiosity and initiative |( extremely well |( very well |( moderately well |( not well |

|The applicant demonstrates good problem-solving skills, follows | | | | |

|through, and completes tasks |( extremely well |( very well |( moderately well |( not well |

|The applicant’s respect for self and others is |( excellent |( good |( fair |( poor |

Comments:

Appraiser’s Name Title Telephone ( )

Signature Organization Date

Please return completed Appraisal to:

RTAC Scholarship Program

c/o Brian Klemm

204 Loch Ryan Way

Cary, NC 27513

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POST-

SECONDARY

SCHOOL

DATA

UNUSUAL

CIRCUMSTANCES

APPLICANT

APPRAISAL

APPLICATION

CHECKLIST

All materials, including transcript, must be addressed to:

RTAC Scholarship Program

c/o Brian Klemm

204 Loch Ryan Way

Cary, NC 27513

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