TONY LENZER SCHOLAR APPLICATION

TONY LENZER SCHOLAR APPLICATION
Application Form

(Please complete all sections in its entirety and then click “submit”)
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
College or University you are currently attending*
Degree Program*
Current GPA*
Expected Date of Graduation*

MonthDayYear
Date
Relevant Academic Coursework: Credit courses or internships you have taken in the past or are currently taking, specifically related to aging, long-term care and/or death and dying. Indicate the institution offering the course, and when it was taken. *
Relevant Non-Credit Learning Experiences: Conferences, lectures, seminars or other non-credit activities you have attended or are currently attending, specifically related to aging, long-term care, and/or death and dying. Indicate the name of the activity and when it was taken.*
Aging-Related Volunteer Work for a Community Organization, Public Agency, or Legislative Body, or unpaid caregiving experience with an older person: Indicate the name of the organization(s), describe your volunteer or caregiving work, dates, and duration (number of months). *
Aging-Related Paid Employment: Indicate the name of the employing organization(s), your job title(s), a brief description of your responsibilities, and when and for how long (number of months) you were employed. *
Describe Interest in Gerontology and Future Career Goals: Be detailed and specific. *
Suggested word count: 300-500 words
Financial Need: Describe and be as specific as possible. *
Suggested word count: 200-300 words
Upload pdf of your latest transcript (an unofficial transcript is fine). *

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Upload pdf of a letter of recommendation from an academic advisor, instructor, or supervisor.*

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