Rosy Baker Scholarship Application

Rosie Baker Scholarship Application
Purpose of Scholarship:
To encourage eligible WCCAA members to pursue educational opportunities to enhance their preset or future job responsibilities and career opportunities in the field of early care and education. The scholarship funds could cover the cost of training up to $500 in a calendar year, not to exceed $1,000 in a three-year period. Schoarlships will be approved as budget allows. Scholarship will not include travel, mileage, or housing.

Eligibility:
Must be a current WCCAA member for at least one year before applying.
You may apply for only one scholarship per year.
Must apply prior to the event or training.
Application must be completed IN FULL to qualify.
All required materials MUST be submitted with this application.
SECTION 1 - APPLICANT INFORMATION
Name *

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Best Phone Number to be Reached *

Area Code Phone Number
Name of Current Employer / Organization
Organization Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Work Phone Number

Area Code Phone Number
Work Email
example@example.com
Job Title
WCCAA Region: *
WCCAA Membership ID: *
Have your received the Rosie Baker Scholarship in the past? *

Yes No
If Yes, What years did you receive it?
If Yes, please share how it benefited you and your community, region, and/or WCCAA:
Section 2 : REQUEST INFORMATION
Type of Event

Conference Training
Title of Event - Include adequate information:
Location of Event (City, State, Zip):
Date(s) of Event:
Cost of Event:
Amount Requested from Scholarship:
Have you already registered for this event?

Yes No
If No, please provide an explanation:
If Yes, who should reimbursement be made payable to:
Section 3: SCHOLARSHIP REQUIREMENTS
Please attach a resume or bio:

Browse Files

Cancel of
Submit documentation for the cost of the event:

Browse Files

Cancel of
Please provide a brief description for the purpose of attending this event and how it will benefit you, your center and the community.
SECTION 4: APPLICANT AGREEMENT
Please read and check the follow agreement: *

Within 30 days of completion of event, I agree to submit a short summary on how this event has helped me in the field of Early Care and Education to the Rosie Baker Committee. This will be posted on Facebook, the WCCAA website and posted at conference with my name and photo listed. I understand my payment of my scholarship will be submitted directly to the agency or person that made the payment, upon submission of proof of payment, proof of the completion of the event and the short summary with photo. I understand that failure to fully complete this form will disqualify me from the Rosie Baker Scholarship and my submission will be void.
SECTION 5 - ADDITIONAL INFORMATION
Applicants must submit all required documentation to the Rosie Baker Scholarship Committee on or before the deadline of each scholarship opportunity.
Signature of applicant *

Clear
Date *

Month Day Year
Date
Thank you for applying to the Rosie Baker Scholarship! A member of WCCAA will be in contact with you.
Should be Empty:

Rosie Baker Scholarship Application

SECTION 1 - APPLICANT INFORMATION

Section 2 : REQUEST INFORMATION

Section 3: SCHOLARSHIP REQUIREMENTS

SECTION 4: APPLICANT AGREEMENT

SECTION 5 - ADDITIONAL INFORMATION