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Sealant, Waterproofing & RestorationfoundationScholarship Application

Student Education Scholarship Application FormMail this completed form, along with requested materials to SWRInstitute Headquarters. (Please print or type)Name of ApplicantDateDate of BirthSocial Security NumberCurrent AddressCity/State/ZipPermanent AddressCity/State/ZipTelephoneE-mailCountry of CitizenshipNames of Parent(s)Address of Parent(s)City/State/ZipInstitution AttendingAddress of InstitutionCity/State/ZipTelephoneYear and Semester Enrolled as a Student (ex. Fall ‘10)Degree Pursuing (Associate, Bachelor, Other)How and where did you hear about the scholarship? __________________________Source of Funding for Education: Parents______% Loans______% Scholarships______% Part/Full Time Job______% Grants______%In an attachment, please list other scholarships/grants received and source and amount for each.Include with application form:A typed and signed statement of your activities, interests,anticipated employment (if any), prospective field of study,and the career path you expect to follow. Statement shouldnot exceed 500 words in length.An outline of your proposed program of study indicatingyour intent to pursue an education in the field ofconstruction, specifically in the sealants, waterproofingand restoration industry.Official copies of college transcripts. Students who haveattended college full-time for two semesters or more arenot required to submit high school transcripts.A typed statement from an instructor knowledgeable ofyour desire to pursue a career in the construction industry(for high school students) OR a letter of recommendationfrom the department head or dean of the college (forcollege students). Two typed letters of recommendation. Itis preferred, but not required, that one of these letters besubmitted by someone in the sealant, waterproofing andrestoration industry (i.e. current or past employers, localconsultants, professional architect, engineer, industrycontractor, etc.).The following persons have been requested to write letters regarding my qualifications, character and abilitiesand instructed to send them directly to SWRInstitute headquarters.*(It is the responsibility of the applicant to ensure letters are received by SWRInstitute headquarters.)NameTitle/PositionAddressNameTitle/PositionAddressNameTitle/PositionAddressIt is my understanding that the SWR Foundation Student Education Scholarship is granted for the purpose of helping me secureeducational opportunities related to or which could be used in the sealant, waterproofing and restoration industry.SignatureDateMail this completed form, along with the requested attachments to:SWR Foundation • 400 Admiral Blvd. • Kansas City, MO 64106 • 816.472.7974 • 816.472.7765 fax

Sealant, Waterproofing & RestorationfoundationSWR FOUNDATION400 Admiral blvd.KANSAS CITY, MO 64106