Washington State Environmental Health Association

 GRADUATE SCHOLARSHIP APPLICATION

 

 

Applicant's Name:                                                                                                                                                        

 

Current Address:                                                                                                                                                      

 

                                                                                                        Phone No.:                                          

 

Permanent Address:                                                                                                                                                 

 

                                                                                                                                                                                

 

 

Instructions:

 

1.     Fill in the following information:

        a.     College/university to which you have been accepted for graduate studies:                                  

                __________________________________________________________________________

                Degree you are seeking:                                                                                                                            

        b.     Colleges/universities attended and degree(s) earned:                                                                       

                                                                                                                                                                                     

                                                                                                                                                                                     

 

        c.     List any previous honors/awards (including scholarships):                                                             

                                                                                                                                                                                     

                                                                                                                                                                                     

 

2.     Attach a copy of your university/college transcripts to this application form.

 

3.     Attach a brief biographical sketch (one page), describing your work history in environmental health,  your interests, and your goals for using your graduate education.

 

4.     Sign the application form.

 

5.       Ask your adviser or other qualified individual who can comment on your academic performance to complete the information requested on the back of this form and mail it to the Washington State Environmental Health Association, 103 Sea Pines Lane , Bellingham , WA   98229-9363 .

 

Applicant's Signature:___________________________________________   Date:____________