Diversity, Equity & Inclusion Scholarship Application Form

Deon Hornsby Diversity, Equity & Inclusion CPRIA Scholarship Application Form

Application Deadline - July 17, 2026
Read and follow the instructions carefully prior to submitting your application. The scholarship recipient will be notified the first week of August 2026.
If selected, you will be asked to complete all six CPRIA courses starting with Segment I in August 2026 and concluding with Segment VI in Summer 2027. Please make sure that you will be able to complete the courses during this time. For exact course dates, please refer to the calendar here. All correspondence and award agreements will be generated from the personal information submitted below.
I. Personal Data

Tell us about yourself
Full Name*

First NameLast Name
Mobile No*

Area CodePhone Number
Email *
Where the confirmation will be send to
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please check your status at the time of application.*

I am a HNW Personal Lines ProducerI am a HNW Personal Lines Account ManagerI am a HNW Personal Lines UWOther
Have you previously taken any of the Chartered Private Risk and Insurance Advisor (CPRIA) courses?*

YesNo
Have you submitted an application for the DE&I Scholarship previously?*

YesNo
Does your employer provide education expenses?*

YesNoNot Sure
How long have you worked in the High Net Worth industry?*
For which Company are you currently employed?*
II. Personal Essay
Please share why you should be considered for the CPRIA scholarship and how taking and earning the CPRIA designation will advance your professional career as well as your personal goals. Your essay is limited to no more than 500 words.
Essay*

0/500
III. Letter of Recommendation

Please provide one (1) letter of recommendation from an individual that has first-hand knowledge of your work ethic, personal integrity, and why you are a great recipient for the CPRIA designation.
Letter of recommendation

Browse Files

Cancelof
IV. Applicant's E-Signature
By signing the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Signature*

Powered by Jotform SignClear
PRMA is committed to equal opportunity in employment and education. PRMA does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

Deon Hornsby Diversity, Equity & Inclusion CPRIA Scholarship Application Form

I. Personal Data

II. Personal Essay

III. Letter of Recommendation

IV. Applicant's E-Signature