Teacher Trust Fund Scholarship Application Form

IndividualScholarship ApplicationIndividual Scholarships will be presented to FMSEA members to attend either anenvironmental professional development program or a professional conference (FMSEAannual conference included). Awards may cover registration, travel or accommodationcosts. Applicants are encouraged to secure matching funds from sources other thanFMSEA. All award winners must agree to:• acknowledgments of FMSEA support in all activities related to the funded program,• filed copies with FMSEA of all products/projects generated by the program,• a short, written report on the program/conference for the annual FMSEA Journal orpresent a session at the first FMSEA Annual Conference after the completion of theproject.Submitting an application does not guarantee funds will be awarded.Name:Home Address:City: State: Zip:Home Phone:Work Phone:Email Address:School/Organization:Work Address:City: State: Zip:Grades/Subjects taught:I’ve been a FMSEA member since: County/District:TOTAL AMOUNT APPLYING FOR: $To fund what program/conference?Signature:Date:FMSEA_ISA_120301

IndividualScholarship ApplicationDescribe the program of conference you will using this scholarship for (why is itimportant to attend; what will you get out of attending; how will it help you improve inyour position; etc.)Do you have matching funds (both in-kind goods and services can be used)? If so,please explain:How will you present your report on the program/conference? Choose one:A session at the next FMSEA conferenceArticle in FMSEA Annual JournalPlease include the following with your scholarship application:oooBudgetBrief Bio or resuméRegistration form (if applying for funds to attend FMSEA Annual Conference)Incomplete applications will not be considered. Scholarship Applications are due 60days prior to program/conference for which you are applying.Mail or (email) completed application packet to:Heather Segura701 Channelside DriveTampa, FL 33602Phone: 813-273-4186Email: president-elect@fmsea.orgFMSEA_ISA_120301