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Contact Information |
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Name |
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Institution |
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Local Address |
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Local City, State, ZIP |
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Local Phone |
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E-mail |
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Year in School |
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Major (undergrad) |
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Minor |
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Field of Study (grad) |
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Anticipated Graduation Date |
month/year |
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Student Development Opportunity Applying For (check all that apply) |
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WIRSA State Workshop |
Date
start date
- end date (month/day/year) |
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Student Lead-On |
Date
start date
- end date (month/day/year) |
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NIRSA National Conference |
Date
start date
- end date (month/day/year) |
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Officials Clinic/Tournament |
Date
start date - end date (month/day/year)
Location
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Other |
Date
start date - end date (month/day/year)
Name
Location
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Scholarship Agreement |
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All applicants are responsible for reading the Student
Development Scholarship
Information Sheet. By checking the box below, applicant is indicating that
information sheet has been read and understood. |
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Yes, I have read the
Student Development Scholarship Information Sheet and agree to abide by all terms and meet the application requirements. |
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Additional Information |
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To complete application process, the following additional items must be
submitted |
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electronically as an e-mail attachment to
mcalpine.maur@uwlax.edu. |
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Materials must be RECEIVED no later than 30 days prior to
event. |
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1. Current resume. |
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2. On a separate sheet of paper, provide the following information: |
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a. Itemized budget to include registration fee, travel mode and cost,
lodging and meal fees. |
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b. List your student development opportunities experienced on your campus,
in your |
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community, and at the state, regional, and/or national level. |
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c. List and explain your leadership experiences. |
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d. Do you currently work in your campus recreational sports program?
If yes and |
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information is listed on your resume, indicate "see resume". If not
indicated on resume, |
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please list and explain your work capacity in recreational sports on your
campus. |
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e. In 250 words or less, briefly explain how you became involved in the
field of recreational |
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sports, what your current level of involvement is, and the benefits you derive
from your |
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involvement. |
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f. In 250 words or less, briefly explain what benefits you will gain from
the student |
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development opportunity applied for, what unique qualities you will bring to the
experience |
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that will benefit others in attendance, and how you will share your new
knowledge with |
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your campus upon return from your experience. |
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Director/Chair Contact Information |
Please provide the following contact information for the Director of
Recreational Sports or Department Chair at your institution. This person may be
contacted to verify that the eligibility requirements listed below have been
met:
1. Enrolled as undergraduate or graduate student or completing internship at a
Wisconsin institution during the academic term for which funds are received.
2. Employed by the campus recreational sports program at current institution
and/or enrolled in a degree program studying recreation or a related field,
OR
3. Serve as committee member for campus recreation-related committee. |
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Name |
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Title |
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Department |
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Phone |
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E-mail |
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Recommendation Form |
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Please have a supervisor (if work-related application) or instructor (if
academic-related application) complete and submit one recommendation form on
specific WIRSA Student Development Scholarship
Recommendation Form.
Form must be RECEIVED no later than 30 days prior to event. |
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Thank You |
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Thank you for your application to the WIRSA Student Development Scholarship.
You will receive electronic notification of scholarship winners upon completion
of the selection process. Please refer to WIRSA Student Development Scholarship
Information Sheet for additional information. Direct further inquiries to: Mo
McAlpine, WIRSA Scholarship Committee Chair, 608-785-8698,mcalpine.maur@uwlax.edu.
All materials must be RECEIVED NO LATER than 30 days prior to event. |