NAEA Education Foundation Special Enrollment Exam Preparation

Section A: Contact Information

Name: ______Last First MI

NAEA Associate _____ yes _____ no NAEA ID: ______

Is this a: _____ new application or _____ request for continuation of a scholarship for the online course

Address: ______

City, State, Zip Code: ______

Phone: ______Fax:______

E-mail: ______

Important Information, read carefully the instructions and do not skip any step:

Qualifications: . All sections of the application must be filled out before the application is evaluated. . Your initial application must be accompanied by two letters of recommendation. Requests for continuation of a scholarship for the online course do not require letters of recommendation. . You must have a high school diploma, GED, or the equivalent. . Your initial application must be received and/or post-marked a maximum of two months in advance of the local conference you plan to attend. Requests for continuation of a scholarship for the online course must be received at least three weeks prior to the start of the course. . Scholarships are only given for SEE courses offered through NAEA or NAEA State Affiliates. Scholarships for NAEA’s online SEE Prep course are awarded per part.

All applications are reviewed by the NAEA-EF Scholarship Committee and decisions will be based on financial and career needs as well as background in taxation. Notification will be sent via email to the address shown on this application. Please notify NAEA if your contact information changes.

Section B: Education Information

Years of Education Completed and Major Course of Study (Please check the most recent and indicate major course of study to the right of the box):

o High School or GED o Associate Degree o Graduate Degree o Some College o Bachelors Degree o Masters Degree Section B1: Your Experience in the Field of Taxation

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Section C: Applicants Statement of Need

Educational or Professional Goals:______

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Section D: Financial Information

Are you applying for: _____ NAEA’s Online Instructor Led SEE Prep Course Part 1

_____ NAEA’s Online Instructor Led SEE Prep Course Part 2

_____ NAEA’s Online Instructor Led SEE Prep Course Part 3

_____ State Affiliate SEE Prep or Review Course State Affiliate offering course: ______Total Cost of Course and Materials: ______Dates of Course: ______Have you applied for a scholarship from any other source? ____ yes ____ no If yes, from what source? ______Have you been awarded a scholarship from any other source? ____ yes ____no If yes, from what source? ______

Scholarship funds for NAEA’s Online Instructor Led courses will be automatically applied towards your registration (you must still register for the course on the NAEA registration form). Scholarships for State Affiliate Courses will be paid directly to the State Affiliate. Please provide a copy of the registration form for the purposes of transmittal of the scholarship funds (you must still register for the course with the State Affiliate). Funds will only be dispersed to the scholarship candidate if proof of payment is provided and prior approval has been granted. Section E: Applicants Essay

Please answer the following questions in 75 words or less:

What is an Enrolled Agent? ______

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Should you pass the exam, how do you intend to use the license?

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Additional information that you would like us to consider:______

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______Please tell us how you heard about the NAEA Education Foundation scholarships for the SEE prep ______

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I hereby certify that all statements in this application are true to the best of my knowledge. I understand that falsification is cause for voiding this application.

Signature______Date______

Submit applications to the NAEA-EF Scholarship Program, Attn: Clarise Diggs, Programs Manager, 1120 Connecticut Avenue, NW, Suite 460, Washington, DC 20036 or Fax: 202- 822-6270.