Fillable Wyoming Association of Public Accountants (Laramie County Community College)

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Wyoming Association of Public Accountants (Laramie County Community College)

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Produced by LCCC Public Relations PRS 9237 12/09
Wyoming Association of
Public Accountants
SCHOLARSHIP APPLICATION FUND
For Wyoming Students Enrolled in the Pursuit of Accounting Education
MICHAEL LIESCH, Pres. JARVIS WINDOW
PO BOX 25 1064 GILCHRIST ST
THERMOPOLIS, WY 82443 WHEATLAND, WY 82201
307.864.2888 307.332.3433
mleischpa@directairnet.com Jarvis@coffey.com
1.800.491.3028
Scholarship Criteria:
1. Your application will be evaluated in part on how well you follow instructions
when you complete this form.
2. All information provided by applicants will be considered confidential.
3. To receive WAPA Scholarship Funds, candidates must be Wyoming Residents
enrolled or accepted by an accredited school within the State of Wyoming
as full-time accounting or business related student carrying a minimum of
12 credit hours.
Application Deadline: April 1
Name in Full
First, Middle, Last
Present Address
Street
City, State, ZIP
Phone Number
Permanent Address
Street
City, State, ZIP
Phone Number
U.S. Citizen Yes No State of Wyoming Resident Yes No
Length of residency in Wyoming:
years
Marital status: Single Married Separated Divorced Widowed
Ages of children (if any)
If married, Name of Spouse
Spouse’s Occupation
Professional field you plan to enter
Name and Address of the College, Community College or University you plan to attend
Name
Address
Street
City, State, ZIP
Degree to be received
Date you plan to attend: (MM/YY)
From to
Have you applied for admission to the school? Yes No
Have you been accepted? Yes No
(PLEASE SEND US A COPY OF YOUR LETTER OF ACCEPTANCE.)
Are you an existing student at the school? Yes No
List High School from which you graduated and Colleges you have attended:
Name of School City & State From – To Major Field
Degree
Earned
High School
College
Please submit your transcripts from high school and college. If a transcript is
unavailable by the April 1 deadline for applications, submit your application without
the transcript but tell us when the transcript will be available.
Explain any unusual circumstances regarding your financial status in the following
space. It may be to your advantage, for instance, for the committee to know your family
size or special needs.
Employer and Job Description Full/Part-time Dates of Employment
References
When you supply information requested below, you are giving
the committee permission to contact your references.
Personal Character Reference
Address
Street
City, State, ZIP
Phone Number
Professional Reference
Address
Street
City, State, ZIP
Phone Number
Submit a brief paragraph giving your reasons for wishing to study in the professional
field of accounting. (Example: When did you first become interested? What
opportunities have you had to observe the practice of the profession? )
If your previous education has been interrupted because of illness, employment,
finances, travel, etc., please explain.
Because competition for awards may be very great, in the question below it will be to
your advantage to clarify the need for financial assistance as completely as possible:
Projected School Costs
Your school year is _____ Months _____ Quarters _____ Semesters
Tuition
Food and Housing
Personal
Books and Supplies
Transportation
Other Personal
(Daycare, monthly payments, insurance)
Your sources of financial support:
SOURCE
Approximate annual income of
source, if applicable
Estimate amount of support
in dollars you will receive
from this source
Parent or Guardian
Spouse
Self
Others (Financial Aid, Social
Security, other scholarships, etc)
Areas of your special interest and proven leadership ability:
List of other scholarships for which you have received or will receive:
STATEMENT OF APPLICANT
If I am granted a scholarship, it is my intention to complete the education program
outlined. I agree to inform the Wyoming Association of Public Accountants Scholarship
Fund immediately if I am no longer interested in preparing for the profession indicated
of if my plans change. I also agree for WAPA to publish my name and awards in their
material.
I agree that this application and all credentials submitted by me or others on
my behalf will remain the property of the Wyoming Association of Public Accountants
Scholarship fund.
By checking this box, I hereby certify the provided information is accurate to the
best of my knowledge. I also certify that I will allow the Scholarship and Financial
Aid Office at LCCC to release any information that is applicable to this application.
_____________________
Date
Submission Instructions
Submit application before April 1.
Please note the pop-up window that appears after you
click Submit.
1. The window will ask you to select your e-mail client.
2. If you use Microsoft Outlook Express, Microsoft
Outlook, Eudora or Mail, click “OK” in the pop-up
window. The form will be e-mailed to us.
3. If you use any other client, such as Yahoo or Hotmail,
choose “Internet Email,” then click “OK.”
• The computer will save the form to your hard drive.
• Open your e-mail account.
• Attach the form to a message and e-mail it to
FinancialAid@lccc.wy.edu.
4. Please contact Financial Aid at 307.778.1156 to make
sure the form was received successfully.
SUBMIT
or
PRINT
and mail to: Laramie County Community College
Scholarship & Financial Aid Office
1400 E. College Drive
Cheyenne, WY 82007
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Completed 27 July 2020

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