SCHOLARSHIP AWARD INFORMATION

NIAGARA COUNTY DEPUTY SHERIFF'S ASSOCIATION
WWW.NCDSA.ORG

P.O. Box 58
Newfane, New York 14108

SCHOLARSHIP AWARD

Eligibility Requirements:

• Each applicant is eligible for one $1000.00 scholarship each calendar year.

• The applicant must be seeking a degree in a Criminal Justice field.

• Applicants may either be full-time or part-time students.

• Applicants may apply for the scholarship in each year that they attend college
level courses. Receipt of the scholarship in one year does not disqualify them in future years.

• Please print out the below form and legibly print or type all information.

• ALL ENTRIES MUST BE POSTMARKED NO LATER THAN MAY 15th

2012 Applicant Information

Name: _________________________________________________________________

Address: _______________________________________________________________

City, State, Zip: __________________________________________________________

Telephone: ______________________________

School Name: ___________________________________________________________

Grade Point Average (include transcript):______________________________________

Extra-Curricular activities - Please include information on any activities you regularly
participate in, including sports, hobbies, clubs, etc. Also include any awards you have
received.

_______________________________________________________________________

Please explain why you are pursuing a career in the Criminal Justice field. Include
information on the specific field you are currently exploring, and what you hope to
achieve in your career. (If you prefer, print your answers on a separate sheet of paper.)

________________________________________________________________________

How do you plan to further your development in a criminal justice career? Include the
college you plan on attending, the course of study you intend to pursue, and any other
activities or training programs you are currently considering. (If you prefer, you may
print your answer on a separate sheet of paper.)

________________________________________________________________________

List three (3) character references (not relatives):

Name:Street:

City, State, Zip:

Telephone:

Name:

Street:

City, State, Zip:

Telephone:

Name:

Street:

City, State, Zip:

Telephone:

When filling out your application form, please ensure that all questions have been
answered. An incomplete application may result in rejection.
Identify all attachments.

ALL STATEMENTS ARE SUBJECT TO VERIFICATION

I affirm that the statements made on this application, including any attached papers,

are true. I also authorize any designee of the Niagara County Deputy Sheriff's

Association to conduct an investigation to verify any information included in this

application.

_________________________________________________
Signature of Applicant

_______________________
Date

_______________________________________________________
Signature of Parent or Legal Guardian

______________________
Date

Return Application to:

Niagara County Deputy Sheriff’s Association

ATTENTION: SCHOLARSHIP AWARD

P.O. Box 58

Newfane, New York 14108

Home