Elsie Schrader Grant-In-Aid Scholarship Application




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Washington Federation of State Employees, Olympia, Local 443

Post Office Box 105

Olympia, WA 98507-0105
Elsie Schrader Grant-In-Aid Scholarship Application
▪ Grants are for one quarter only and applications must be filed immediately after the start of the quarter.

▪ File separate application for each quarter with-in 30 days of the quarter beginning.

▪ You must attach proof of enrollment for the quarter in which you are applying.

Statement of Facts

To be completed by the applicant (type or print in ink)

Personal Information
Name:
Address:
Phone Number: E-Mail: ____________________
Phone Number:
Agency: _______________________________________ Current job class _________________________
Hours per week__________________________________ When did you join the union?________________


Financial Information

List all sources of additional income including, but not limited to Social Security, Unemployment Compensation, Workman’s Compensation, Child Support, Alimony, Public Assistance, Food Stamps, Pension, Rental Property, Investments, etc.

Number of Dependents: ____________________________ Ages: _________________________________


Gross Income Earnings: ____________________________ Spouse’s gross income: __________________
Combined gross monthly income: ___________________________________________________________
Approximate combined net income per month: _________________________________________________
To assess your financial need, we need to understand your combined net income – all income less expenses. Give pertinent information regarding your income and financial obligations to support net income (i.e. amount of rent/mortgage payment, child support, car payment, utilities, loans, etc.) that would be helpful in assessing your financial need. Attach additional page if necessary. (This section is very important.)
Explanation of net income (see box above)
CAREER AND SCHOOL PLANS
Name of Institution offering class:_________________________________________________________
Name of classes requested: _____________________________________________________________
Total credit hours per quarter: _____________ Inclusive dates of course(s) _______________________
Immediate career goals: ________________________________________________________________
How many further requirements are there for completing your immediate career goal:_________________

Have you applied for any other scholarships? ______________ If so please list: ____________________________________________________________________________________________________________________________________________________________________________


Are you receiving tuition assistance? _____________________If so please explain: ____________________________________________________________________________________________________________________________________________________________________________
Your costs associated with this course: Tuition $_______________ Books $________________________
Miscellaneous costs $_________________________
In applying for the scholarship described in this application form, I certify that all the facts contained herein are correct.
Date: ________________ Signature: _______________________
Mail application and transcript within 30 days of registration to:

W F S E Local 443

Attention Scholarship Committee

Post Office Box 105

Olympia, WA 98507-0105


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