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Charles W. Cummings Scholarship Application
Individuals applying for the CC Scholarship should complete this application.
Name *
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Phone *
Your answer
E-mail *
Your answer
Are you a MO-CASE Supporter? *
Required
Are you a CEC Member? *
Required
What is your current position and district? *
Your answer
How long have you been in your current position? *
Your answer
What is your current certification? *
Your answer
Please list the current University you are attending, Major or Course of Study, and GPA: *
Your answer
Please list contributions you have made to the field of Special Education and/or administration: *
Your answer
Please provide professional activities and service: *
Your answer
How will this scholarship be used to assist you in attaining a post-graduate degree in special education administration or in attaining special education administration certification? *
Your answer
Please provide a narrative describing your future professional goals and aspirations. *
Your answer
ADDITIONAL DOCUMENTS NEEDED
Please mail the following to MO-CASE, 3550 Amazonas Dr., Jefferson City, MO 65109 or FAX to (573) 644-7806. They must be received by May 1st.
* Professional Resume
* Current Transcript
* Three letters of recommendation including one from your current employer/supervisor
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