Professional Documents
Culture Documents
We look forward to hearing about your experience and sharing this with our organization. Thank you for participating and please forward your essay submission (along with your application and transcript) to: By Mail Mr. Jody Paul Ragonese NYCorp College Scholarship Fund Committee 145 Airline Road Clinton, CT 06413 BY Email jody.ragonese@comcast.net By Fax (866) 454-3935
New York Relocation Council (NYCorp) 2014 College Scholarship Fund Application Application must be received by NYCORP no later than April 1, 2014
Please type or print clearly Name Address City Telephone High School State Email Address Current Grade Month/Year You Relocated Zip
Old Location:
New Location:
Was your family part of a company-sponsored relocation? What company? Extracurricular Activities List? Honors, and AP classes in which you are currently enrolled:
Please continue on a separate page any additional Honors/AP classes and/or extracurricular activities. I certify that the work I am submitting with this application is entirely my own and that the information I have provided on and with this application is true to the best of my knowledge. I consent that my guidance counselor/high school relinquish my personal information listed on the following page.
_______________________________________________ SIGNATURE
Page 1 of 2
________________________________ DATE
Grade Point Average List most recent test scores (SAT, ACT, etc.) Name (High School Official) Title (High School Official) Phone
DATE _______________
Please email your NYCorp College Scholarship Fund Coordinator with any questions.
Use one of the following to submit your application, activities list and transcript DEADLINE: April 1, 2014
By E-mail: The Essay should be emailed in a Word document format to: jody.ragonese@comcast.net By Fax: (866) 454-3935
Committee 145 Airline Road Clinton, CT 06413 BY Email jody.ragonese@comcast.net By Fax (866) 454-3935
Page 2 of 2
I, , the undersigned, hereby authorize the NYCorp and its representatives, successors, and assigned, to use my name, photo, and written essay (or portions thereof) about my relocation (that accompanied my NYCorp 2014 scholarship application) for publication. I represent and warrant that the attached statement represents my true opinion. I further represent that I am of legal age and have every right to grant these rights.
Date
Name (printed)
Signature
I represent that I am a parent/legal guardian of As their parent/legal guardian, I have the legal authority to grant the right set forth above.
Date
Name (printed)
Signature
Please return with your application packet. By Mail: Jody Paul Ragonese 145 Airline Road Clinton, CT 06413 By Email: Jody.ragonese@comcast.net By Fax: (866) 454-3935