2025 CPCU Designation Scholarship: College Student Application

2025 CPCU Designation Scholarship: College Student Application
Name*

First NameLast Name
Personal Email*
example@example.com
Work / School Email*
example@example.com
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permanent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number*
Please enter a valid phone number.
Birth Date*

MonthDayYear
Date
College / University Information
College / University Name*
Major*
Year of Study *
(Freshman, Sophomore, Junior, or Senior)
Expected Graduation Date*
(MM/YYYY)
Nominator's Name *
Nominator's Email*
example@example.com
Transcript (Unofficial transcript accepted)*

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Letter of Recommendation (Must be from the department chair or college dean nominator listed above)*

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Personal Statement *

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Essay: What do you believe are the most pressing challenges facing the insurance industry today, and how would you approach solving them as a future leader?

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DISCLAIMER:

I certify that I am currently a full-time student and that all the information I have provided on this application is true, correct and complete.

I further authorize The Institutes to obtain additional information to verify the content of this application.
Signature*

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College / University Information