Scholarship Application

Scholarship Application
Eligibility

- Must reside in and attend School or Academy in Ashtabula, Columbiana, Mahoning, Portage, Stark, Summit and Trumbull Counties

- Scholarships are for Fire, EMT or Paramedic Students.

Information about scholarship process

*Once application form is received with the essay it will then be presented to Randall S. Pugh Memorial Fund Board members for discussion and vote on approval or denial of application.

*Maximum Scholarship awarded is $1,000

*These are rolling applications and are accepted all year.

*Student will be notified if approved for Scholarship. Funds will be sent directly to the School or Academy.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Where are you planning attending program?
Education you have completed? Ex. Highschool diploma, GED, Some college, College Degree or Certificate Program.
Are you planning on attending an EMT, Fire or Paramedic program?
Amount of funding you are applying for? $
Are you willing to be on our social media pages or website with a write up about you along with your picture?

YesNo
Are you willing to volunteer or speak at one of our Fundraising events?

Yes to bothNo to bothYes to VolunteerYes to Speak
ESSAY: AFTER SUBMITTING THIS APPLICATION PLEASE EMAIL AN ESSAY (500 TO 1000 WORDS) ON WHY YOU DESERVE THIS SCHOLARSHIP AND HOW IT WILL HELP YOU ACHIEVE YOUR EDUCATIONAL AND CAREER GOALS. PLEASE ALSO ATTACH TO EMAIL 1 LETTER OF RECOMMENDATION WITH ESSAY. EMAIL ESSAY AND LETTER OF RECOMMENDATION TO: RANDALLPUGHMEMORIALFUND@GMAIL.COM. THANK YOU FOR YOUR INTEREST IN A SCHOLARSHIP FROM RANDALL S. PUGH MEMORIAL FUND.
Date

MonthDayYear
Date
Signature: I hereby declare that the information provided in this application is true and accurate to the best of my knowledge.

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