Heating, Ventilating, Air Conditioning, Refrigeration, and Water Heating Industry

Attracting the Brightest Students to the Heating, Ventilating, Air Conditioning, Refrigeration, and Water Heating Industry

SCHOLARSHIP APPLICATION FORM

A. PERSONAL INFORMATION

NAME: STUDENT ID NUMBER:

HOME ADDRESS: PHONE (xxx-xxx-xxxx):

E-MAIL:

DATE OF BIRTH (mm/dd/yyyy):

B. EDUCATIONAL BACKGROUND

HIGH SCHOOL: GPA: OUT OF SCHOOL ADDRESS: CREDENTIAL EARNED:

DATES ATTENDED (mm/dd/yyyy): TO

C. OTHER BACKGROUND

SCHOOL NAME: GPA: OUT OF SCHOOL ADDRESS: CREDENTIAL EARNED:

DATES ATTENDED (mm/dd/yyyy): TO

D. EMPLOYMENT HISTORY

POSITION TITLE: DATE OF EMPLOYMENT (mm/dd/yyyy): TO NAME/ADDRESS OF EMPLOYER: SUPERVISOR NAME:

SUPERVISOR TITLE:

SUPERVISOR PHONE (xxx-xxx-xxxx):

1 Attracting the Brightest Students to the Heating, Ventilating, Air Conditioning, Refrigeration, and Water Heating Industry

POSITION TITLE: DATE OF EMPLOYMENT (mm/dd/yyyy): TO NAME/ADDRESS OF EMPLOYER: SUPERVISOR NAME:

SUPERVISOR TITLE:

SUPERVISOR PHONE (xxx-xxx-xxxx):

E. FUTURE EDUCATIONAL INFORMATION

SCHOOL NAME: HVACR INTRUCTOR OR DEPARTMENT HEAD NAME:

SCHOOL ADDRESS: DEPARTMENT:

PHONE (xxx-xxx-xxxx):

E-MAIL:

Have you applied? If yes, have you been accepted? YES NO YES NO

HVACR PROGRAM YOU PLAN TO ATTEND: Is this program accredited through the Partnership for A/C, Heating, Refrigeration Accreditation (PAHRA)? YES NO

Have you taken any of the three Industry If yes, confirm which were taken and provide the score: Competency Exams (ICE)? RESIDENTIAL A/C AND HEATING SCORE: YES NO LIGHT COMMERCIAL A/C AND HEATING SCORE: COMMERCIAL REFRIGERATION SCORE:

What is the total cost of your education for the next year (include books, fees, and tuition)? $ What other scholarships and/or grants have you received this year (include funding amount)?

F. ADDITIONAL INFORMATION

Please let us know if there are other aspects you would like us to consider, such as yearly medical cost, transportation issues, special needs, etc.

Where did you learn of the CLIFFORD H. “TED” REES, JR., Scholarship Foundation?

I believe all of the above information to be true and complete and I hereby apply to the Clifford H. “Ted” Rees, Jr., Scholarship Foundation for a scholarship. I authorize the Foundation to obtain and review my academic records, including but not limited to official transcripts. I understand that any misrepresentation of the information contained in this application may revoke any rights to an award. In signing below, I agree to hold the Foundation harmless for any and all liability for damage, injury, or loss sustained by me in connection with this application, including but not limited to, the acquisition by the Foundation of my academic records.

PRINTED NAME: SIGNATURE: DATE (mm/dd/yyyy):

Please submit the following with this completed application: - Two letters of recommendation typed on letterhead - Typed essay of no more than 500 words on why this scholarship should be awarded to you - Copy of Alien Registration Card (if applicable)

- Official transcripts (from high school, college, or university) sealed or provided directly by the school.

Complete and send this application with supporting documents to [email protected]. Please send all sealed, official transcripts to the address below:

Air-Conditioning, Heating, and Refrigeration Institute (AHRI) Clifford H. “Ted” Rees, Jr. Scholarship Foundation 2111 Wilson Boulevard, Suite 500, Arlington, VA 22201 ATTN: Misha Adams

Phone: 703-524-8800 * Fax: 703-562-1942 * E-mail: [email protected]

Rees Scholarship Foundation Application Checklist

Please be sure to submit the following items with your application:

 Two letters of recommendation (from present or past employers, present or former teachers, or other professionals) typed on letterhead.

 A typed essay of no more than 500 words that explains why the applicant would like to be considered for a Rees Scholarship and how the scholarship will help him or her financially and career-wise. The essay also should demonstrate educational potential based on prior education or work history.

 Copy of Alien Registration Card and a letter of the nominee's intent to become a United States citizen, if applicable.

 Official transcripts (from high school, college, or university) sealed or provided directly by the school.