2017-2018 KATIE SCHOOL SCHOLARSHIP APPLICATION

Deadline: Monday December 18, 2017–432 SFH Katie School Office

The Katie School Scholarship Selection Committee will use information from this form, as well as other relevant information, to reward students for past performance and to encourage future achievement in the study of insurance. Please attach separate sheets of paper that detail any additional information you would like to share with the Selection Committee along with a copy of your resume, the signed Katie School Ethics Pledge and the Authorization Form for Release of Student’s Judicial Record.

Please type this form neatly, accurately and completely! Inaccurate, incomplete and/or sloppy applications will not be considered.

Name______UID #

Local Address & City______Phone______

Permanent Street Address______City, State & Zip______

E-mail______County______

Major______ISU Cumulative GPA______

Minor______Expected Graduation Date______

Community College and CC GPA (if applicable)______

Courses Completed (Grade), In Progress (IP), or Planned (List Semester to be Taken)

FIL 250______FIL 351______FIL 354______FIL 345 FIL382.05

FIL 350______FIL 352______FIL 355______FIL 398.10

Gamma Iota Sigma (GIS) Insurance Fraternity

Semester and Year Joined______Leadership Activities within GIS______

Katie School/Gamma Iota Sigma Events and Industry Involvement

Please check the following activities in which you have participated in the fall semester:

August 25-27 – Gamm Iota Sigma Leadership Conference☐

August 31 – Festival ISU☐

September 7– Katie Advisory Board☐

September 9–Home Sweet Home Ministries Volunteering☐

September 12–Travelers Day☐

September 12First General Meeting☐

September 13- Mid-IL RIMS Lunch☐

September 14– Internship Fair Professional Development☐

September 16 – Habitat for Humanity Volunteering☐

September 18 –Great American Information Session☐

September 18–CNA Diversity and Inclusion Panel☐

September 19– M3 Insurance Lunch and Learn☐

September 19– Fall Internship Fair☐

September 20– NAPLSO Internship Info Session☐

September 21– ALB Golf Outing☐

September 21– Clean the Quad☐

September 22– Katie Alumni/Student Golf Outing☐

September 25-26– WNET Mock Interviews☐

September 26– CPCU Society Expo☐

September 27– HDI Info Session☐

September 26-28 - National Risk Retention Association Confer.☐

September 28 – October 1– Gamma Nationals☐

October 2– Aon Day☐

October 3 – Fall Career Fair☐

October 6– Midwest Food Bank Volunteering ☐

October 9-10– Chicagoland Risk Forum☐

October 12– Swiss Re Day☐

October 13– Swiss Re Interviews☐

October 13– Home Sweet Home Ministries Volunteering☐

October 16– Blanket Making Volunteering☐

October 17– Mid-IL RIMS Lunch☐

October 18– Healthcare Financial Management Panel☐

October 19– Gamma Iota Sigma Bowling☐

October 19-20– Troy University Symposium☐

October 20– Gamma Alumni Council Symposium☐

October 23– Amica Mutual Insurance Lunch and Learn☐

October 24– Cards for Veterans☐

October 25– Katie School Executive Forum☐

October 25– Halloween Policy Fundraiser☐

November 1– Speed Networking☐

November 3 – Midwest Food Bank Volunteering☐

November 3– Business Writing and Web- Literacy Seminar☐

November 6-7– Risk Manager in Residence☐

November 7– Gamma Birthday Party ☐

November 8– 3rd General Meeting☐

November 9– Blood Drive ☐

November 10– Captives Lunch and Learn☐

November 13– International Internship Info Session ☐

November 14– Mid-IL RIMS Lunch ☐

December 5– 4th General Meeting☐

December 6 –Lunch with Endowed Chair Candidate☐

Certificate of Leadership & Business Acumen ☐

Industry Research Project ☐

Toastmasters ☐

Other

Internships in Insurance or other Work Experience (please describe)______

______

Other Relevant Insurance Industry Involvement (please describe)______

______

Insurance Licensing and Professional Designations – Exam Parts Completed or Passed

Property/Casualty License______CPCU Exams Passed______

Life/Health License______CLU Exams Passed______

Series 6______SOA Exams Passed______

Series 7______CAS Exams Passed______

Volunteer WorkDuring College

List Organization, Title (if any), Date of Involvement and describe Role______

______

______

______

Other Campus Involvement and Personal Accomplishments

Use this space to include any other accomplishments of which you wish the Committee to be aware.

If you are selected as an award recipient, would your parents likely attend the Recognition Program in April?

Parents’ name(s):

Parents’ address (es):

Name of Hometown Newspaper:

Essay

Please attach a one-page, typed, single-spaced essay, on the following topic:

“What I Hope to Accomplish in the Next Five Years and What I Am Doing Now to Prepare for It.”

**Please submit your Application, Essay, Resume, signed Katie School Ethics Pledge and

Authorization Form for Release of Student’s Judicial Record **

Signature______Date______

With my signature, I certify that the information given in this application is accurate, to the best of my knowledge.