Vermont State Employees' Association Scholarship Application

Vermont State Employees' Association Scholarship Application
The VSEA Awards/ Scholarship Committee is currently soliciting applications from students seeking financial assistance in the pursuit of postsecondary educational goals. The Committee will announce the recipients of the scholarships at the June Council Meeting. The guidelines are as follows:

Applications will be considered from persons entering or engaged in:
- Educational or vocational degree or licensed programs
- Course(s) to further skill development
- Self-improvement courses
Those persons eligible for scholarship consideration are as follows:
- VSEA members
- VSEA members’ dependents
- VSEA members’ dependent step-child
- VSEA members’ spouses/domestic partners
The Scholarship Committee will base its decision for the scholarship eligibility on the following criteria
- Career goals
- Financial need
- Abilities and initiative
- Life experiences
- Class standing (recent graduates)
- Community and school involvement
Scholarship amounts vary each year. The VSEA Awards and Scholarships Committee reserves the right to determine the amount of each scholarship award, based on available funds.

Requirements

The VSEA Scholarship Application must be completed in full, with the appropriate accompanying materials, including:
- General information
- Employment history
- Educational background including high school/ college transcripts
- Please submit copies of most recent W2 tax forms to show proof of family income (either by attaching to this form or email to vsea@vsea.org)
- One written letter of reference
- A brief essay on your career/employment goals
- Optional: Other information (i.e., resume, personal statement) that provide an overview of your academic/work record or ability.
Deadline

VSEA Scholarship applications are due on May 6.

Aimee Bertrand Staff Liaison, VSEA Awards and Scholarships Committee Email: vsea@vsea.org

You can also print a copy of this application, scan and email it, or mail to:

VSEA Awards/Scholarship Committee

c/o VSEA Headquarters

155 State Street

Montpelier, Vermont 05602

The PDF version of this application can be downloaded here.
- General Information
- Name*
  
  First NameLast Name
- Date of birth*
  
  MonthDayYear
  Date
- Mailing Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Legal address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Daytime phone*
  Please enter a valid phone number.Format: (000) 000-0000.
- Evening phone*
  Please enter a valid phone number.Format: (000) 000-0000.
- Personal email address*
  example@example.com
- VSEA memberVSEA member's dependents, children, or step childrenVSEA member's spouse or domestic partner
- If applying as the spouse/domestic partner or dependent, child or step child of a VSEA member, please provide the following information:
- Full name of VSEA member:*
- Applicant's relationship to VSEA member*
  I.e. Spouse, step-daughter, etc.
- Position/job title*
- Department and work location*
- Employment History
  
  Note: You may attach a resume if you choose, instead of using the fields below
- YesNo
- (1) Employer/work location*
- (1) Position/job title*
- (1) Dates of employment*
- (2) Employer/work location*
- (2) Position/job title*
- (2) Dates of employment*
- (3) Employer/work location*
- (3) Position/job title*
- (3) Dates of employment*
- (4) Employer/work location*
- (4) Position/job title*
- (4) Dates of employment*
- (5) Employer/work location*
- (5) Position/job title*
- (5) Dates of employment*
- Educational background
- List the name of any schools attended, the town/state located, and date of graduation/degree*
  I.e. "Montpelier High School, Montpelier Vermont, 2019"
- List any school activities participated in
- List any community activities participated in
- Educational pursuits
- What degree or course work are you pursuing?*
- List all schools to which you have applied, their location, and state if you have been accepted:*
  I.e. "Johnson State College, Johnson Vermont, Accepted"
- What courses do you plan to take?*
- What is the length of your desired course/degree program?*
  (I.e., weeks, months, years)
- What is the adjusted gross income for the household from all sources? (use previous year’s tax form):*
- If your household is receiving child support payments, please list total dollars received in child support during previous year: *
- Note: Please attach copies of your parents’ W-2 form(s) from the previous year if you are a dependent. You can also email them to CNeubieser@vsea.org. If you declared taxes and you are not living with your parents, please submit copies of your own W-2 form.
- What is the number of persons included in this household?*
- How many people in your household (other than yourself) are attending college?*
- What are the school costs for the following (if exact costs not known, please estimate):
- Transportation:*
- Meals:*
- Books:*
- Child care:*
- Housing:*
- Other school expenses you will incur (please explain):*
- Explain in your own words why you are seeking financial assistance. Provide any income or expense information that you believe will be useful to the committee in determining financial need. If you have any unusual financial expenses (medical, household, etc.) that impact your financial situation, please feel free to explain.*
- List all other financial aid sources applied for in this educational pursuit (including loan programs, tuition assistance, etc.) and indicate the status of each (i.e., denied, approved amount, pending, etc.:*
- Declaration to be completed by VSEA member
- I hereby attest that I, Members' name* am responsible for the financial/educational support of Dependent's name*.
  Date of signature*
  Signature*
- Declaration to be completed by the applicant
- I hereby attest that I, Applicant's name* am responsible for the financial/educational support of .
  Date of signature*
  Signature*
- I will be attaching documents to this formI will be emailing documents to Carter Neubieser
- Provided below is a checklist of the items that should be sent along with this Scholarship Application. Please take a minute to review and check off the items in the list to ensure you have prepared your application properly for consideration. Please check the documents which you have submitted. (* indicates required items. If any of these items are missing your application will be disqualified.)*
  
  High school/college transcripts*Copies of W-2s from parents/guardians (if you were a dependent in previous year), or from yourself*Brief essay on educational / career goals*At least one written letter of reference*Other not required information: resume, personal statement
- File Upload
  
  Cancelof
- Should be Empty:

Vermont State Employees' Association Scholarship Application

General Information

If applying as the spouse/domestic partner or dependent, child or step child of a VSEA member, please provide the following information:

Employment History

Educational background

Educational pursuits

Declaration to be completed by VSEA member

Declaration to be completed by the applicant