You can apply for the scholarship by filling out this form or by contacting our Scholarship Co-Chairs: Barbara Manuelpillai and Cheryl Reed at scholarship@wsninc.org.

Please read the information sheet before filling out this form. Please do not submit the form if you are not eligible. Only eligible candidates will receive a response.

Please submit by April 30:

Name:
Email:
Phone:
Address:
City:
State:	Zip:
1. GOALS: Describe your educational and career goals and the timeframe involved in achieving them, including any obstacles you have had to overcome.
2. PROGRAM: Identify the specific course or program you will use the scholarship money for and its total cost.
3. BACKGROUND: What is your educational and career background? Please be as specific and chronological as possible.
4. RESOURCES: What other financial resources do you intend to use to complete your education?
5. PARTICIPATION: Please describe your participation in your local community, such as volunteer work, etc.
6. ACHIEVEMENTS: Are there any personal or scholastic achievements that you would like to add?
7. MORE?: Is there anything further you would like the committee to consider as part of your application?