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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 CMITWinter2019@kitanonprofit.com. 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 CMITWinter2019@kitanonprofit.com. I am happy to answer your questions!

Full Name *
Address *
Email *
Phone number *
Please list the languages that you speak fluently. *
Required
Please describe any language proficiency testing results you may have completed and send copies of the results to CMITWinter2019@kitanonprofit.com 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? *
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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
Mornings
Afternoons
Evenings
Nights
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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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