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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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