Eric Flannery Line of Duty Scholarship Application Applicant Information First Name (required) Last Name (required) Street Address (required) Address Line 2 City (required) State (required) Zip (required) Phone Number (required) Email (required) Date of Birth (dd/mm/yyyy) (required) Gender Public Safety Relationship (To be eligible to apply for a scholarship, they MUST be the child (natural or adopted) of an active, retired or deceased public safety personnel within Maricopa County.) Name of public safety parent(s) or legal guardian(s) (required) First & Last Name (required) First & Last Name (required) Public Safety Department or Agency (required) Address of public safety parent(s) or legal guardian(s) (required) City (required) State (required) Zip (required) Phone of parent(s) or legal guardian(s) (required) Academics What is the name and location of the High School currently attending? (required) When will you graduate? (mm/dd/yyyy) (required) Applicant Cumulative Grade Point Average (GPA) on a 4.0 scale: (required) Applicant School Transcript (required) Are you the first person in your family to go to college? (required) Yes No What College, University or Post-secondary Trade School will you attend upon graduation? Please list school name and location. (required) Activities, Interests & Honors List any academic honors, awards and membership activities while in high school: List your hobbies, outside interests, extracurricular activities and school related volunteer activities: List your non-school sponsored volunteer activities in the community: Essay (250-500 words) Describe how volunteer or community service has shaped who you are today and what community service has taught you. Also, discuss in your essay about any challenges or obstacles you have dealt with and overcome in life and how this will help you succeed in college and beyond. (required) Support Materials Letter of Recommendation #1 (must contain contact information) (required) Letter of Recommendation #2 (must contain contact information) (required) Resume/Activities Sheet Statement of Accuracy for Students I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that if chosen as a scholarship winner my picture may be taken and used to promote the scholarship program. (Winner may waive photo due to unusual or compelling circumstances.) I hereby understand that if chosen as a scholarship winner, according to Daisy Mountain Firefighters Scholarship policy, I must be present at any potential awards ceremony, surprise, or reception to receive my scholarship award. I hereby understand that if chosen as a scholarship winner, according to Daisy Mountain Firefighters Charities Scholarship policy, it is my responsibility to remit to the Daisy Mountain Firefighters Charities the appropriate information for my scholarship to be paid directly to my educational institution. I hereby understand I will not submit this application without all required attachments and supporting information. Incomplete applications or applications that do not meet eligibility criteria will not be considered for this scholarship. (required)I agree with the above statement. There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
