Guided Partners in Safety (GPS) Scholarship - Application
The Law Office of Chain | Cohn | Stiles, which focuses on helping accident and injury victims in the Central Valley, has introduced the "Guided Partners in Safety (GPS) Scholarship,” aimed to financially support local high school students through their driver’s education training while keeping safety at the forefront.
To be eligible for the GPS Scholarship, please fill out the application below. Additionally, a current high school transcript must be emailed to gpsscholarship2020@gmail.com
Submit transcript with student’s first and last name in the subject line.
Name *
First and last name
Your answer
Age *
*15 - 17 years of age (Must turn 15 years of age in 2020)
Your answer
Address *
City, State, Zip
Your answer
Email Address *
Your answer
High School *
Full Name of High School
Your answer
Year in High School *
Freshman, Sophomore, Junior, Senior
Your answer
Creative Essay (200-word maximum) *
"Why Do You Want To Drive?"
Your answer
Photo/Video/ Media Release Permission *
I hereby give permission to CHAIN COHN STILES to use images and video of myself captured on video and photography to be used for the purpose of law firm marketing, promotional materials, and publications, and I waive any rights of compensation or ownership thereto. I understand and consent to CHAIN COHN STILES using my likeness in television commercials, internet marketing, and print publications. I understand that I may be identified by name in the aforementioned forms of media. I also understand that I may be identifiable in these photographic and electronic reproductions. This release is valid from today’s date and it will not expire.
Required
Accept (Student Signature) *
By accepting, I acknowledge the information submitted is truthful and factual.
Required
Accept (Parent Signature) *
By accepting, I acknowledge the information submitted is truthful and factual.
Required
Date *
MM
/
DD
/
YYYY
Submit
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