BEA SCHOLARSHIP APPLICATION FORM #1 – Applicant Information

BEA SCHOLARSHIP APPLICATIONFORM #1 – Applicant InformationScholarships for Academic Year 2011-2012NOTE: This application MUST be typed to be considered. Applications not typed will bedisqualified. FOUR complete copies must be submitted. Make sure each copy is collated andsecurely stapled.1. NAME:PREFERRED ADDRESS:City: State: Zip:PHONE:FAX:E-MAIL:IMPORTANT:I certify that I will be a full-time student at a BEA member school FOR THE ENTIRE 2010-2011 ACADEMIC YEAR. (Two semesters/three quarters)SIGNATURE:DATE:2. CHECK EACH SCHOLARSHIP FOR WHICH YOU ARE APPLYING. (The descriptionand criteria for each scholarship can be found on the announcement flier. You may compete forall for which you are eligible, although you can be chosen for only one.)SCHOLARSHIPWalter PattersonHelen Sioussat/Fay WellsAlexander M. Tanger2-Year-BEA AwardAbe VoronVincent T. WasilewskiVISION AwardRichard Eaton AwardSPONSORED BYNational Association of BroadcastersBroadcasters’ FoundationAlexander M. TangerBroadcast Education AssociationAbe Voron CommitteePatrick Communications, LLCVCI SolutionsThe Richard Eaton Foundation1

3. EDUCATIONAL BACKGROUND (Transcripts required from each. Your name mustappear on the transcript. See directions.)Years Attended (from-to)College/UniversityYears Attended (from-to)College/UniversityYears Attended (from-to)College/UniversityPresent Class Standing (for Two Year Students):H.S. SeniorCollege Freshman(All other students)Present College Class:Sophomore Junior SeniorGraduate StudentLaw SchoolIndicate your Cumulative Academic Grade Point Average below (based on a scale of A=4.0)UndergraduateGraduateHigh School (Two Year college students only)If a scholarship is awarded to you, at what institution will you use it?Will you be an undergraduate or graduate student?AT LEAST ONE DEPARTMENT ON THIS CAMPUS MUST BE AN INSTITUTIONALMEMBER OF BEA, IN GOOD STANDING, BY THE APPLICATION DEADLINE.Applications listing ineligible schools will be disqualified. For institutional membership list seewww.BEAweb.org (click on “Scholarships & Grants”) or call 202.429.3935.4. You are responsible for contacting three references and having them send letters ofrecommendation. At least one letter must be from an electronic media faculty member. Pleaselist these three references below (names and titles).(LETTERS OF REFERENCE MUST BE RECEIVED BY OCTOBER 12, 2010)5. Transcripts of all college work: Are enclosed Will be sent .Transcripts MUST be received BY CLOSE OF BUSINESS on October 12, 2010.2

9. PROFESSIONAL ELECTRONIC MEDIA EXPERIENCE: (jobs at stations, networks,studios, agencies, etc.) List most recent first.10. Describe other employment, experience or accomplishments which you feel might bepertinent to this application.11. The following is for statistical purposes only and will not impact committee decisions. It isnot required, but is very helpful in BEA demographic analysis.FemaleMaleAmerican Indian or Alaskan NativeAsian or Pacific Islander __________Black Hispanic White OtherMulti-race_______4

12. Please provide a focused statement of your career goals IN NO MORE THAN 250 WORDS.SUBMIT FOUR COPIES OF THIS COMPLETED APPLICATION TO:Dr. Peter B. OrlikScholarship Chairman, BEA344 Moore HallCentral Michigan UniversityMt. Pleasant MI 48859Mailing Date of This ApplicationThis application is not complete until all materials have been received. Incomplete applicationswill not be considered. No faxed or e-mailed material is accepted. Please do not send materialsother than those requested. They cannot be reviewed by the committee.DEADLINE FOR SUBMITTING ALL APPLICATION MATERIALS:BY CLOSE OF BUSINESS ONOCTOBER 12, 2010NO FAXED OR E-MAILED MATERIAL WILL BE ACCEPTED5