The Oregon Chapter of the American Public Works Association

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Scholarships for Members and Their Employees

Application Form

$1,000 will be available each year for in-service training of APWA members and their employees.

REQUIREMENTS  

Oregon Chapter APWA Member/Employee
Scholarship Application

Name  _______________________________________________________

         First                                Last                                                  M.I.

Address  _____________________________________________________

City ____________________________ State _____ Zip ______________

Home Phone ___________________ Office Phone ___________________

FAX _________________________ E-Mail __________________________

Job Title _____________________________________________________

Firm or Agency _____________________________ Employed since _____

Supervisor  ___________________________________________________

College/Univ  _________________________________________________

Course No./Title  _____________________________ Start date _______

Employer ____________________________________________________

Costs:  Tuition/Fees ________ Books ________ Reimbursement _______

Reason(s) for attending_________________________________________

_____________________________________________________________

_____________________________________________________________

Applicant Signature ____________________________ Date ___________

Supervisor Signature* __________________________ Date ___________

Submit this application to:

Oregon APWA Scholarship Committee
Attn:
Victoria Saager
Washington County LUT
1400 SW Walnut Street
Hillsboro
, OR 97124
503-846-7616
Fax 503-846-7620

e-mail:
  Victoria Saager

*By signing this form, employer certifies that applicant is a full-time employee, and that the scholarship funds will not be used in place of employer training funds.

Page last updated July 24, 2008

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