DESK AND DERRICK EDUCATIONAL TRUST PART I
SCHOLARSHIP APPLICATION
2022-2023 ACADEMIC YEAR (Fall and Spring Semesters)
A scholarship program for assistance with tuition and books, managed by the Desk and Derrick Educational Trust, is
offered to qualified student citizens of the United States or Canada who have completed two years of undergraduate studies
with a minimum 3.2 overall grade point average on a 4.0 scale (United States) or 80% and above (Canada) and are enrolled
in a full-time program (co-op programs do not qualify). Applicants must be pursuing a degree in a major field of study related
to qualifying for full-time employment (in the petroleum, energy, or allied industries) and have need of financial assistance.
Scholarships awards will be split between Fall and Spring semesters.
Please complete both pages of this application. Completed applications must be received at the office of the Desk and
Derrick Educational Trust on or before April 1, 2022. This application is available at theeducationaltrust.org in a fillable
PDF format. All information must be furnished; ILLEGIBLE OR HANDWRITTEN applications will NOT be considered
(excluding Part II).
Name: Date of Birth:
Student ID Number: Sex: Female Male
Citizenship: United States Canada __ _ Daytime Phone:
Permanent Address:
Current Address:
Email address at school: Home Email address:
Declared Major Field of Study: Degree Sought (B.S., B.A., M.S., Ph.D.):
College or University: Estimated Date of Graduation:
High School: High School Location (City/State):
I hereby authorize and request the Student Financial Aid Office of
College or University Name
to release the following requested information to the Desk and Derrick Educational Trust.
Signature of Applicant Date
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PART II
THIS PORTION TO BE COMPLETED BY STUDENT FINANCIAL AID OFFICE TO VERIFY ENROLLMENT
1. Overall grade point average: __________ Total current college credits: __________ In good standing? _______
2. Full or Part-time? ________ Undergraduate or Postgraduate? ________ Declared major: __________________
3. Copy of complete transcript.
4. Do you expect the student to receive any financial aid in the 2020-2021 school year? Yes _____ No _____
If so, the estimated amounts of financial aid: Grants __________ Scholarships __________ Loans ___________
Work-Study __________ Other Aid ________________________ Student has NOT applied for financial aid: ___
5. Estimated cost for a full-time student at your institution for the current year: Tuition/Fees ____________________
Books & Supplies ____________ Room/Board ____________ Transportation/Other _______________________
__________________________________________ _____________
Printed Name
Signature Date
__________________________________________________________
Title Email Address Phone Number
__________________________________________________________
Name of University University Tax ID Number
__________________________________________________________
University
Mailing Address
__________________________________________________________
City State/Province Zip/Postal Code
