California School Psychology Foundation

Paul Henkin Scholarship Application

APPLICATION DEADLINE: September 1, 2013

Dear Applicant:

Thank you for your interest in the Paul Henkin Scholarship. The award, up to the amount of $750.00, is to be used to attend the annual CASP convention. Funds are to be applied toward registration and workshop costs, lodging and transportation. Funds cannot be used for food, drink, materials or other expenses incurred while attending the convention. The award is not renewable.

Two awards will be made annually to CASP members; one to a graduate student in school psychology, and one to a newly credentialed school psychologist. A newly credentialed school psychologist is defined as someone who has received a credential within the last three years.

Scholarship applications will be evaluated based on evidence of knowledge of the demands of the vocation of school psychology as well as an understanding of the importance of continuing professional education.

Applications and letters of reference must be postmarked or emailed by September 1. Please mail your application to Paul Henkin Scholarship, C/O CASP, 1020 12th St., Suite 200, Sacramento, 95814. Email to .

Please Note: Applicants may not apply for both the Paul Henkin Convention Scholarship and the Cultural and Linguistic Diversity Scholarship in the same year.


California School Psychology Foundation

Paul Henkin Scholarship

Graduate Application

Part I: Personal Data

1. Name: ______

Last First Middle

2. Address: ______

Number Street City Zip

3. Home Phone: ______E-Mail: ______

4. Current School Psychology Program: ______

College/University GPA

5. Year of Study: 1st yr.____ 2nd yr.____ 3rd yr.___ Intended date of graduation: _____

Part II: References

Submit one letter of reference from a college professor supporting your application for this award.

Part III: Essay

Attach a 300-word essay describing how your attendance at the convention will benefit your future professional practice as a school psychologist.

Part IV: Other Information

Submit a resume of you academic, employment and extracurricular experiences and achievements.

I ascertain that the information submitted in this application is true and accurate. I additionally agree to the stated guidelines of the application, as well as to abide by the decision of the CASP Foundation Scholarship Application Review Committee.

______

Print Name Signature

______

Date Social Security Number (SSN)

California School Psychology Foundation

Paul Henkin Scholarship

Professional Application

Part I: Personal Data

1. Name: ______

Last First Middle

2. Address: ______

Number Street City Zip

3. Phone: ______E-Mail: ______

4. School Psych. Program: ______

College/University Year Graduated

5. Date of credential as a School Psychologist: ______

6. Current Employer: ______

7. Current Job Title: ______

Part II: References

Submit one letter of reference from your administrator/supervisor supporting your application for this award.

Part III: Essay

Attach a 300-word essay describing how your attendance at the convention will benefit your professional practice as a school psychologist.

Part IV: Other Information

Submit a resume of you academic, employment and extracurricular experiences and achievements.

I ascertain that the information submitted in this application is true and accurate. I additionally agree to the stated guidelines of the application, as well as to abide by the decision of the CASP Foundation Scholarship Application Review Committee.

______

Print Name Signature

______

Date Social Security Number (SSN)