Scholarship Nomination Form 1. To be eligible, you must : a. Be currently enrolled in a school. b. Be the child, step child, or grandchild of a NMIADA member in good standing c. Possess an excellent school record of academic achievement . d. Demonstrate an aptitude for college/ trade school 2. Please complete this form and return it to the NMIADA office. All information supplied by you to the Selection Committee of the NMIADA and will be treated with security and confidentiality. If selected, however applicants agree that personal information and photos will be used at our discretion. 3. List the College, Colleges, Universities, and Trade Schools you have applied to or are attending, and provide documentation as such. It is the nominee’s responsibility to make all the arrangements for college admission. 4. 5 Scholarships in the amount of $1000.00 will be awarded to the winning nominees with an outstanding high school/college/ trade school record of achievement and evidence of excellent aptitude and passion. 5. Scholarship recipients will be announced at the 2019 NMIADA Scholarship luncheon at our Annual Convention. 6. The scholarship will be funded upon verification of enrollment. APPLICATION DEADLINE : June 30TH, 2019.
Date of Application: _____________ Date of Graduation/Enrollment: ___________ Applicants Date of Birth: ________________ Name ( First/ Middle/ Last): ____________________________________________________________________________ Home Address: _________________________________ City: _____________Zip: _________ Primary Phone Number: __________________ E-mail: _______________________________ High School Last Attended (name): _______________________________________________ Address: _____________________________ City: ____________________ Zip: __________ Other Schools Attended (if applicable): ____________________________________________ Address: _____________________________ City: ___________________ Zip: ____________ Parent(s)/ Legal Guardian? Grandparent(s) Name (MUST BE A CURRENT NMIADA MEMBER): ___________________________________________________________________________ Firm Name: ____________________________________ Dealer Number#: ______________ Relationship to Applicant: ______________________________________________________ Address: ____________________________________________________________________ City: _____________________________ Zip: _________________ Phone#: ______________ Hometown News Paper Name: __________________________________________________ Address: _____________________________ City: ___________________ Zip: ____________
APPLICANT MUST ATTACH THE FOLLOWING: A list of schools to which scholarship applicant has been accepted/applying to/attending. List of major projects, activities, and accomplishments. A list of High School extracurricular activities, offices and distinctions An essay in support of nomination for a scholarship (please limit your statement to 2 pages) Discuss relationship with NMIADA, scholarship sponsor, current education goals, and future aspirations relating to subject/training area. A recent photo (color portrait, 4”x6”) Applicant’s High School Transcripts or GED or current collage transcript with official university imprint. Up to 3 letters of recommendation from applicant’s high school principal, teacher’s community, etc. A brief statement that may be published in NMIADA publications should the applicant be selected
When completed by ty you, you must return this form with ALL attachments to:
NMIADA 604 Chama St NE Albuquerque, NM 87108 Attn: Scholarship Program OR Scan and Email as PDF to:
[email protected] ( Please include in the subject line: “NMIADA SCHOLARSHIP APPLICATION”)
Signature of Nominee: _________________________________________________________ Signature of Parent/Guardian: ____________________________________________________
