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 1 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 [email protected]. Documents must be postmarked no later than April 17, 2015. 2