Scholarship Form

ASIS FOUNDATION, INC.
Scholarship Application

Eligibility:  Open to ASIS members and other students of merit who are interested in the security profession and who have demonstrated a potential to make a contribution to the field of business security.

A minimum grade point of 3.0 (on a 4.0 scale) is required for graduate students. Undergraduate grade point requirement set by local ASIS chapter.  Applicants may be part-time or full-time students at an accredited college, university, or community college.  Scholarships will be awarded on a calendar year basis, January 1 through December 31.
Student Requirements:

  • Complete and submit application to chapter.
  • Submit transcript to chapter.
  • Submit faculty member letter of recommendation to chapter.

Address of Puget Sound Scholarship Review Committee:

FOR CHAPTER USE ONLY

Date Received______ Student Notification______ Faculty Letter Received______

Transcript Received__________________ Check sent to ASIS Foundation______

Matching Scholarship?____ (Only one chapter scholarship per calendar year will be matched)

Student Information:

(Please print clearly)

Name__________________________________________________________________

SSN#____________________________Home Telephone (____) ___________________

eMail Address:_______________________________________________

Home Address___________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

School Address__________________________________________________________

______________________________________________________________________

______________________________________________________________________

School Telephone (____)__________________________________________________

Major _________________________________________________________________

Courses taken relevant to security (if any):__________________________________

______________________________________________________________________

______________________________________________________________________

Name and phone number of faculty member sending recommendation: ___________

______________________________________________________________________

Cumulative grade point average __________________________________________

(must also submit an official copy of your transcript)

Current and/or previous security or related work experience:_____________________

_______________________________________________________________________

Future career plans: ______________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Future academic plans (advanced degrees, courses, etc.):_______________________

_______________________________________________________________________

_______________________________________________________________________

Academic and/or professional memberships: __________________________________

_______________________________________________________________________

_______________________________________________________________________

Briefly explain your interest in the security profession:__________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

______________________________ ________________

Applicant’s Signature Date

FOR CHAPTER USE ONLY

CHAPTER REQUIREMENTS CHECKLIST

_____1 Ensure student requirements have been met.

_____2 Select one matching scholarship winner.

_____3 Ensure all award checks are processed through ASIS Foundation, Inc. Headquarters for IRS compliance purposes.

_____4 Send copy of application for all award recipients to ASIS Foundation, Inc. Headquarters.

_____5 Send Regional Vice President a copy of the application for matching scholarship winner.

_____6 Acknowledge receipt of candidate’s application.

Chapter Statement:

Is this your one chapter matching scholarship selection? Yes______ No______

Is the matching scholarship winner an ASIS chapter member? Yes______ No______

In order for you candidate to receive the one matching scholarship and/or be eligible for the Regional Vice President award, the following statement is required:

I attest to the fact that ______________________________ (name) has met the minimum selection requirements as stated in the ASIS Foundation, Inc. Scholarship Policy for the awarding of the ____________(year) matching scholarship from Chapter____________________________(name and number).

_________________________________________________________________

Signature of Chapter Chairman Date