2025-2026 APPLICATION

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Offered by

THE AMERICAN INSTITUTE OF POLISH CULTURE
1440 79th Street Causeway, Suite 117, Miami, FL 33141

All Required Materials must be in our office by Midnight, June 30th, 2025
NO EXCEPTIONS PLEASE.

Announcement of awards by September, 2025

Email *

I AM APPLYING FOR: *

HARRIET IRSAY SCHOLARSHIP

LENNOX FAMILY AWARD FOR EXCELLENCE

First Name/Last Name *

Pick One *

Mrs

Mailing Address *

Permanent Address

Telephone *

Would you like us to add your email to our mailing list? *

Yes

Place of Birth *

Date of Birth *

YYYY

Father's Name *

Father's Occupation *

Father's Telephone *

Father's Date of Birth *

YYYY

Father's Place Of Birth *

Father's Ethnic Background *

Father's Present Address *

Mother's Name *

Mother's Occupation *

Mother's Telephone *

Mother's Date of Birth *

YYYY

Mother's Place Of Birth *

Mother's Ethnic Background *

Mother's Present Address *

Present Citizenship

You must be a U.S. citizen or a permanent resident.

Name of the school in which you are currently enrolled *

I am a *

Freshman

Sophomore

Junior

Senior

What is your present major? *

What is your intended major? *

What fellowships or financial grants do you presently hold, if any? *

How much financial aid do you expect to receive for the academic year?

List all grants, scholarships, loans and other support for which you have applied

How much financial aid will you receive monthly from your parents? *

List honors and distinctions you have achieved as a student *

Have you published any articles, theses or books? if so, please indicate their titles, place and date of publication. *

How would you rate your knowledge of the Polish language? *

None

Poor

Fair

Good

Excellent

What are your interests and activities outside of schoolwork or professional activities? *

RECOMMENDATION LETTERS

List three (3) professors, other professionals or authorities in your field who can attest to your academic or professional ability. Please request recommendation letter from these individuals.

The letters must be mailed or emailed (from the recommender's professional email address) directly to the Institute and they must be ORIGINAL, SIGNED and on LETTERHEAD paper.

1. Name *

1. Title or Position *

1. Address *

1. Telephone *

2. Name *

2. Title or Position *

2. Address *

2. Telephone *

3. Name *

3. Title or Position *

3. Address *

3. Telephone *

IMPORTANT

You must ask your school to mail (preferable) or email (from school email address) your official transcript to the Institute. If not presently enrolled in any school, send the transcript from the last school which you attended.Note that all information you have provided in this application will remain confidential property of AIPC, and will not be sold nor divulged to any 3rd party under any circumstances.

All documents should be sent to:

AIPC Harriet Irsay Scholarship, 1440 79th Street Causeway, Suite 117, Miami, FL 33141

DATE *

YYYY

I agree that my typed name below will be valid as a handwritten signature to the extent allowed by local law *

I Agree

TYPE YOUR LEGAL NAME *

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