Print out this page and complete Applicant Information & Signature of Application sections. Complete answers to Applicant Questions on a separate paper. Send to address listed below.

Applicant Information

Name:

 

Address:

 

City:

 

State:

 

Zipcode:

 

Work Phone:

 

Home Phone:

 

Fax:

 

Email:

 

Are you a current member of WCCAA?

 

 

Signature of applicant

I certify that all information contained within this application is factual and accurate.

Your signature:

 

 

Date:

 

 

What is the amount of your request?

 

 

ID # (for office use only)

 

ID # (for office use only)

 

 

Send completed application to

Sandra Matter
GEHL-Kids Dept
8200 West Tower Avenue
Milwaukee, WI 53223
sandra.matter@ge.com
Phone: 414.362.2587

Applicant Questions

1. (10 pts.) Are you currently employed or otherwise actively involved in the field of child care and education? If Yes, in what capacity?

 

2. (15 pts.) Please provide a brief autobiographical sketch of yourself professionally, including areas in which your work has involved children and/or families.

 

3. (20 pts.) Describe the purpose for which you are requesting funds. If possible, attach a copy of a brochure or catalogue description of the course or workshop, if applicable.

 

4. (20 pts.) Explain how this scholarship would benefit you as a professional.

 

5. (25 pts.) It is the expectation of WCCAA that recipients will "give back" in some way. Suggestions include presenting a training to a local group, presenting a workshop at the state WCCAA conference or implementing a new program for parents or staff at a center. Explain how you would "give something back" as a result of this opportunity.