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Winter 2019 CMIT Scholarship Application
The deadline for this scholarship application is Tuesday, January 8 at 11:59 PM EST. Submissions after that date will not be accepted. The application consists of:

1. Background Information Questions
2. A Statement of Accuracy and Consent
3. Submit a Resume
4. An Essay

The essay prompt is at the very end of the application and may be submitted separately from this form to In addition, the resume may also be submitted separately. Please note that your scholarship application is not 100% complete until both of these documents are submitted and incomplete applications will not be considered.

If you have any questions at any time, please email Paul Tillier at I am happy to answer your questions!

Full Name *
Address *
Email *
Phone number *
Please list the languages that you speak fluently. *
Please describe any language proficiency testing results you may have completed and send copies of the results to by the deadline (Tuesday, January 8 at 11:59 PM EST) *
Please list any volunteer or community involvement you have completed. Your list should include the following: an event description, dates of involvement, if this was a one-time or recurring event, if you served as an interpreter, and the estimated number of hours you served in the role of an interpreter. *
Are you currently authorized to work in the United States? *
If you receive government benefits, is there a cap on the amount of money you are able to earn each month? *
Do your future plans include staying in Kentucky? *
If yes to the previous question, how long do you plan to stay in Kentucky? *
When are you available to start work? *
Do you have, or can you obtain, a copy of your immunization records? *
Do you receive any kind of assistance from the government that would limit how much income you can receive from working? *
What is your availability to work throughout a regular work week? *
Any time
Not available
Are you able to pay the approximate costs of a background check ($76), a drug screen ($45), and a TB test ($10-18)? *
Please state any information that would be helpful for the scholarship committee to determine your financial need (i.e. other family members in college, strenuous expenses, employment details, etc). *
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