21st ANNUAL
COLLETTE P. LEMAY MEMORIAL
SCHOLARSHIP APPLICATION
SPONSORED BY: LOCAL 2320, IBEW
ELIGIBILITY:
* Children, stepchildren and grandchildren of Local 2320, IBEW, active members in good standing or retirees.
* Acceptance into an accredited college or university, community college or
recognized technical or trade school at the time of the award. Graduate
students are not eligible.
* Only one application will be accepted per individual.
* Scholarship application forms may be photocopied and will be accepted.
DEADLINE DATE:
* Applicationmust be received at the Union Hall by the close of businesson
April 30, 2017 to be considered.
* IBEW, Local 2320, will not be able to advise applicants as to the status and/or
receipt of their applications.
* Only winners will be notified in May of 2017.
AWARDS CRITERIA:
* Three (3) one-time scholarships in the total amount of $2,000 each will beallocated.
Applicant must submit a typewritten, double-spaced essay,with their opinion on the following:Right To Work legislation is filed for decades in New Hampshire and is consistently voted down. Explain why politicians continue to file RTW legislation against the will of the people, and what effect RTW legislation would have on the New Hampshire employee workforce?
Essay must be between 400 – 600 words. Do not send essays separately.
Essays sent separately will not be considered.
* A union member verification form (enclosed) must accompany each scholarship
application to be considered for submission.
* IBEW, Local 2320, Collette P. Lemay Memorial Scholarship Committee will determine the awards. Upon receipt of each scholarship application, the applicant’s
name, union affiliation and union member will be separately indexed. Once completed, this information will then be obscured to assure complete impartiality by
the Scholarship Committee.
PERSONAL INFORMATION
______
NAME
______
HOME ADDRESS
______
CITY STATE ZIP CODE
______
HOME PHONE WORK PHONE (IF APPLICABLE)
UNION AFFILIATION
WHAT IS YOUR RELATIONSHIP TO AN IBEW, LOCAL 2320, MEMBER OR RETIREE?
______CHILD/STEPCHILD______GRANDCHILD
UNION MEMBERS’ NAME ______
MEMBER SINCE: ______
MONTH DAY YEAR
LOCATION OF EMPLOYMENT:______
Please note: In order to be considered for a scholarship, applicant must complete the
Union Member Verification Form and return it together with the essay by the deadline
date.
EDUCATION BACKGROUND
LAST YEAR OF SCHOOL COMPLETED (BY JUNE 30, 2017)
______HIGH SCHOOL______3RD YEAR COLLEGE
______1ST YEAR COLLEGE______4TH YEAR COLLEGE
______2ND YEAR COLLEGE
* * * * * * * * * * * * * * * * * * * * * * * * * * * * *
I, the undersigned, certify that all of the information I have included in and with my application is
true. I understand that if I am selected for an award, I may be required to submit further proof
of my relationship to a union member of Local 2320 and of my acceptance to a college, community college, university or recognized trade school. I agree that if I am selected for an award, my name and/or photograph may be used for publicity purposes with no additional
compensation by the sponsors of this scholarship program.
______
DATESIGNATURE
UNION MEMBERSHIP VERIFICATION FORM
This form must be completed by the applicant, verified by the Union Shop Steward or
Local Union Representative, and submitted together with the application in order for the application to be considered for a scholarship.
Name of Scholarship Applicant: ______
(Please type or print clearly)
Union Member Verification:
I, ______, verify that I have been a member in good standing of
IBEW, Local 2320, since ______.
Month/Day/Year
______
Signature of Union MemberDate
* * * * * * * * * * * * * * * * * * * * * * *
Shop Steward or Local Union Representative Verification:
“I verify that the above information is true and complete to the best of my knowledge.”
______
Signature of Shop Steward orDate
Local Union Representative
______
Please print name of shop steward orDaytime phone number of Shop Steward
Local Union Representativeor Local Union Representative
APPLICATION MUST RECEIVED AT THE UNION HALL
BY THE CLOSE OF BUSINESS ON
APRIL 30, 2017
Mail to:Scholarship Committee
C/o IBEW, Local 2320
46 Third Street
Manchester, NH 03102-4596