YPC College Scholarship

Page 1 of 5

YPC Scholarship Form

Attending college for insurance or a related field of study? If so, could you use up to $2,000?

YPC College Scholarship Application Process:
- - Must be sponsored by an active PIA Member *There is NO obligation to purchase insurance from your sponsor. In advance of submitting this application visit the PIAW website to find a PIAW member in your area who would be willing to sponsor you: www.piaw.org - membership/find a member. Make contact and request a sponsorship.
- - Ask your sponsor to prepare a referral paragraph (750 characters, with spaces, or less) in plain text. You will copy and paste this onto the website scholarship form.
- - Have your sponsor information available – name, address, phone, email.
- - Prepare your document on “Tell us your post graduation career plans.” (1500 characters, with spaces, or less) to copy and paste onto the website application.
- - You are now ready to begin the online application.
Recipients will be notified by email.

The PIA of Wisconsin’s Young Professionals Club wishes to award:
Up to $25,000 in scholarships! Scholarships are solely based on sponsorship participation.

To be considered for the scholarship, please submit this form by February 15, 2018.
Please select your application type(*)

High School Application
College ApplicationInvalid Input

Please give us some information about the Student.
Student Name

Invalid Input
Student Address

Invalid Input
Student City

Invalid Input
Student State

Invalid Input
Student Zip

Invalid Input
Student Phone

Invalid Input
College or University registered at

Invalid Input
Education Level(*)

Invalid Input

(i.e. college freshman, college senior, high school senior, etc.)
Field of Study

Invalid Input
GPA (transcrips required if scholarship is granted.)(*)

Invalid Input
Student Email(*)

Invalid Input
Second Email

Invalid Input
School Counselor Email(*)

Invalid Input

Student: In 1500 characters or less tell us your post graduation career plans:
You have characters left.
If you cut and paste your text and it is longer than 1500 characters, it will automatically be truncated
(*)

Invalid Input

Please Copy and Paste your sponsors paragraph(s)
Limit 750 characters or less:
You have characters left.
If you cut and paste your text and it is longer than 750 characters, it will automatically be truncated.
(*)

Invalid Input

Please give us some information about the Sponsor.
Name of Sponsoring PIA Member

Invalid Input
Submitted by

Invalid Input
Agency/Company

Invalid Input
Sponsor Address

Invalid Input
Sponsor City

Invalid Input
Sponsor State

Invalid Input
Sponsor Zip

Invalid Input
Sponsor Phone

Invalid Input
Relationship to student

Invalid Input
Sponsor Email(*)

Invalid Input
Invalid Input
A check will be presented to the scholarship winners at the Opening Party at the PIA Convention in August; you must be present to receive your scholarship. Scholarships awarded at the discretion of PIA of Wisconsin.

Attending college for insurance or a related field of study? If so, could you use up to $2,000?