2015-2016 Scholarship Application - Independent Insurance Agents

Independent Insurance Agents – Rio Grande Valley
2015 – 2016 Scholarship Application
Deadline: April 17, 2015
The Independent Insurance Agents of the Rio Grande Valley (IIA-RGV), is a 501(c)6 non-profit organization dedicated
to promoting the interests of member agencies and their staff.
We are offering two $1000 scholarships and two $500 scholarships. The $1000 scholarships are for applicants
seeking a bachelors or graduate degree from an accredited college or university. The $500 scholarships are for
applicants seeking an associate degree, certification, or insurance designation from an accredited community college,
institute, or organization. To qualify, the applicants must be staff members, or the children of agency owners or staff, from
one of our member agencies. To clarify, “child” means a biological child, adopted child, stepchild, or anyone under a legal
guardianship. Applicants can apply for either a $1000 or a $500 scholarship but not both. Recipients will be
selected based on completeness of the application packet, merit, the personal statement, and the relevancy and value of
any additional information provided. The scholarships can be used toward the cost of attending the school identified in
the application. Past recipients of our scholarship are allowed to apply as long as they were not recipients last
year (i.e., must skip a year).
Contact Information
Last Name
First Name
Middle Name
Street Address
City
State
E-mail Address
Telephone Number(s)
Zip
Qualification for Scholarship
Name of Sponsoring Member Agency :
Affiliation to the member agency – are you:
Staff member?
Child of owner/staff member?
Parent’s Name:
Employment and Education
Are you currently employed?
Yes
No
Current Employer:
Current Job Title:
What is the highest academic degree that you have obt ained to date?
High School
1-Year Certification
2-Year Certification/Associates
Bachelors
Graduate
Other:__________________________________
When did you obtain your most recent academic degree (mm/yyyy)?
Have you completed or are you working on any of the following insurance industry designations:
CIC
CISR
CRM
RPLU
ACSR
Others:___________________________________________________
Academic Goal
What academic degree are you or will you be pursuing?
1-Year Certification
2-Year Certification/Associates
Bachelors
Graduate
Insurance Designation:_______________________________
Other:__________________________________
Name of school/institute/college/university:
Location of school/institute/college/university:
Enrollment date (mm/yyyy):
Expected graduation date (mm/yyyy)?
Major or academic concentration:
Will you be working while enrolled in scho ol?
Yes, Full-time
Yes, Part-time
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No
Applicant’s Name: _________________________________
Scholarship Selection
Select the scholarship amount for which you are applying (only one):
$1000
$500
Extracurricular and Community Service Activities
Activity
Your Role or Function
Date (or date range)
Honors, Awards, and/or Special Recognition
List any honors, awards, and/or special recognition that you have received through your school, job, extra -curricular, or
community service activities.
Personal Statement
In spite of the vast employment opportunities that it offers, the insurance industry struggles to attract young talent. Most
people that come into our industry do so by pure chance. In 500 type-written words or less, on a separate sheet of paper,
tell us why you think the insurance industry fails to attract young career seekers. Include an explanation as to why you
would or would not pursue a career in the insurance industry. Feel free to discuss this with insurance professionals you
many know (i.e., your parents) but the statement must ultimately be your own work.
Additional Information
Submit the following along with this application:
1. Transcript(s) of your most recent completed degree or certification.
2. Most recent transcript of the degree you are currently pursuing, if applicable.
In addition, recipients of the scholarship will need to provide proof of enrollment in the school/institute/college/university
noted in this application prior to receiving the award.
I affirm that the information that I have provided in this application is true and accurate to the best of my knowledge. I
further affirm that the entire content of this application, including the personal statement, is my own work. Finally, I
understand that I will have to provide proof of enrollment prior to receiving my IIA-RGV Scholarship.
Signature of Applicant
Date
Application and all accompanying documents should be mailed to
Juan Padron, 3329 N. McColl Rd., McAllen, TX 78501 or emailed in .pdf format to jpadron@safeguardnow.com.
Documents must be postmarked no later than April 17, 2015.
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