2025 FSA STEM Scholarship Application

2025 FSA STEM Scholarship Application

This scholarship is for the school year beginning in the Fall, 2025. This application must be completed and received NO LATER than February 28, 2025. Applicants will be notified regarding committee review results approximately one month following this deadline. If you have any questions, please contact Harriet Sespico at (850) 877-2165 or hsespico@flsheriffs.org.
Please complete ALL portions of the application below. You will not be allowed to submit the document unless all portions are completed.
Full Name of Applicant, including Middle Name*

First NameMiddle NameLast Name
Home Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
In Fall 2025, I will be a:*
Email:*
example@example.com
Phone Number*

Area CodePhone Number
Date of birth (MM/DD/YYYY)*
If there are extenuating family circumstances that should be brought to the attention of the screening committee, please explain. If there are NO extenuating circumstances, please indicate "N/A".
Please select your ethnicity below.*

African-American/African-CanadianAsian or Pacific IslanderCaucasianMulti-ethnicityHispanicNative American/Aboriginal PeoplesPrefer Not to Say
Gender:*

FemaleMalePrefer Not to Say
My interested career path after college is:*

ScienceTechnologyEngineeringMath
What are your career goals for the next five to ten years?*
List any school and/or community organizations in which you have been active.*
List any leadership positions you have held in school and/or community organizations, and which of those positions you now hold.*
List all awards or commendations you have received, the sponsoring organizations, the reason for your winning, and date of award:*
At least one of the the applicant's parents must be a full-time, paid (sworn or civilian) employee of a sheriff's office in Florida. Please select if your mother, father, or both is/are employed with a sheriff's office below:*

MotherFatherBoth of my parents are employed in a sheriff's office in Florida
Please specify the Sheriff's office your mother and/or father are employed with. *
Please specify the name of your parent(s) that is employed in a sheriff's office in Florida.*

First NameLast Name
Please specify the title/rank your parent currently holds in a sheriff's office in Florida.*
Please provide the name of the community college, college, or university you will be attending in the Fall, 2025: (Must be regionally accredited)*
Address of community college, college or university (please give the address of the department that handles student finances, not the main address):*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list the specific degree (ie Chemistry, Information Technology, Engineering, etc) or certification that you will be working towards.*
Please enter your student ID#, if in college.
Please enter the last four digits of your Social Security Number:*
Please attach a copy of your most recent transcript (high school or college)*

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Please submit below an original essay of at least 500 words (with wordcount) on “What attracted you to your intended STEM field of study and what are your professional goals?”.*

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Attach at least two (2) letters of recommendation. PLEASE NOTE: One (1) must be from a school teacher/professor. These letters should specifically address your qualifications for this scholarship.*

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Please attach a high-resolution color photo (head & shoulder shot) for use in promotional publications.*

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APPLICANT'S OATH & APPROVALS

AS AN APPLICANT FOR AN FSA STEM SCHOLARSHIP, I HEREBY CERTIFY THAT: 1. I know of no physical or psychological limitation I have that would prevent my full participation in a STEM related career; 2. I know of no reason the school or college listed above would not accept me as a full-time student in the Fall 2022; 3. I certify the accuracy and truthfulness of the facts contained in this application; 4. I understand that this scholarship is a one-time award that is limited to $2,000, and should I win the award, that the check will be made payable only to the regionally accredited college or university of my choosing and placed in an account bearing my name. I further understand that I will be allowed to draw against that account for full-time tuition and book expenses only, until the account balance is exhausted; 5. I understand that funding beyond this $2,000 award is not expressed, implied or expected, and that all unused scholarship money which remain on account for me in an "inactive" status for 12 months or more, will revert back to the Florida Sheriffs Association; 6. I understand that the balance of my college expenses (tuition, books, lodging, etc.) above the sum of $2,000 are my responsibility, and not the responsibility of the Florida Sheriffs Association.
Please sign and date below certifying that you have read the applicant's oath and understand and agree to all terms listed above. *

Clear
Date*

MonthDayYear
Date
PARENT/GUARDIAN APPROVAL & WAIVER - REQUIRED

***PLEASE ENSURE THAT YOUR PARENT(S)/GUARDIAN(S) WHO IS EMPLOYED IN A SHERIFF'S OFFICE COMPLETE THE PARENT/GUARDIAN APPROVAL & WAIVER FORM. WE CANNOT CONSIDER YOUR APPLICATION UNTIL WE RECEIVE THE COMPLETED PARENT/GUARDIAN APPROVAL & WAIVER. THIS FORM CAN BE FOUND AT: https://form.jotform.com/242605634438963.
Please check the box below acknowledging that you understand that your parent(s)/guardian(s) who is employed in a sheriff's office will need to complete the online approval and waiver form.*

I understand the above.
PHOTO RELEASE CONSENT
I,   First Name*   Last Name*,

hereby grant the Florida Sheriffs Association permission to use photos of me in the event I am chosen as a recipient of one of their scholarships for use in promotional materials, including but not limited to the website www.flsheriffs.org, in news releases, on social media networks including http://www.facebook.com/floridasheriffsassociation, and in any other promotional materials they so choose. I waive the right to inspect or approve the finished product.

I agree to hold the Florida Sheriffs Association and its employees, contractors, agents, and representatives harmless from any liability to others from the use of anything I may say or do during said photography.

Signature*   (signature of participant or guardian if participant is under the age of 18)
First Name*   Last Name*
Date*
Should be Empty:

2025 FSA STEM Scholarship Application

APPLICANT'S OATH & APPROVALS

PARENT/GUARDIAN APPROVAL & WAIVER - REQUIRED

PHOTO RELEASE CONSENT