College Scholarship

One-year scholarship
Semifinalists will be interviewed and selected by Daikin’s Scholarship Committee

Application Instructions
- All blanks must be completed. If a question is not applicable, please write “N/A” in the answer.
- Transcript from 2023-2024 school year must be included.
- Applications must be signed.
- Application must be received no later than Friday, January 10, 2025.
PART 1: Applicant's Information
Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email
example@example.com
U.S. Citizen*

YesNo
Permanent Zip Code*

7748477447774467744577355773777743377493773637742377868
Names and relationships of any relatives working at Daikin/Goodman
PART 2: Employment History

Briefly describe your work experience, beginning with the most recent employer

	From	To	Employer Name & Address	Salary	Position	Reason for Leaving
1
2
3

What is your career objective?
PART 3: References

List three personal references other than relatives.

	Name	Address	Business	Years Acqntd
1
2
3

PART 4: Education

	Name	City/State	Grade/Decree/Rank/GPA	Dates Attended
High School
Trade School
College/University
College/University
Graduate School

ACT Composite Score
Are you currently a full-time undergraduate college student?

YesNo
Classification for the next Fall Semester

FreshmanSophomoreJuniorSenior
Undergraduate hours completed
Expected college graduation date
Universities applied to or planning to apply
Universities / Colleges where you have been accepted
High School Transcript

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PART 5: Scholarships You Have Already Received

List the amount of Financial Aid/Pell Grant/Scholarships you have already received.

	Name of Financial Aid	Amount	Year
1
2
3
4

PART 6: Service and Volunteer Work

List your volunteer activities that have had an impact on you and those served; especially those STEM focused.

	Activity	Organization	Date	Description
1
2
3
4

PART 7: Awards/Honors Summary

List any awards or honors you have received in recognition of your achievement at work, school, etc.

	Award/Honor	Awarded By	Date	Description
1
2
3
4

PART 8: Special Need
If you have special financial need for a scholarship, briefly describe your situation.
PART 9: Essay
Write how you will use your STEM degree to impact society. Why should you be awarded this scholarship?
PART 10: Photographs
Upload Your Photographs*

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Photograph use consent and release*

I acknowledge that the photographs uploaded may be used, without limitations, in print publications, online publications, websites and on social media.
PART 11: Applicant's Signature

The contents of my application for the Daikin and Waller Area Chamber of Commerce College Scholarship are true and correct to the best of my knowledge
Applicant's Signature

Clear
Date

MonthDayYear
Date Signed
Should be Empty: