2008-2009 Paul C. Roche, Sr. Memorial Scholarship Application

FOR STUDENTS ENROLLED OR PLANNING TO ENROLL AT PENN STATE ERIE, THE BEHREND COLLEGE

Consideration for this scholarship shall be given to all undergraduate students enrolled or planning to enroll at Penn State Erie, The Behrend College, who are in good academic standing or who manifest promise of academic success.  Priority will be given first to students who are children of an employee of Erie Plastics, Inc. Among these applicants, first preference will be given to students majoring in Plastics Engineering Technology; second preference to students majoring in a major within the Sam and Irene Black School of Business or School of Engineering; and third preference to students in any other Behrend major.  If there are no applicants who are children of an Erie Plastics, Inc. employee, then preference will go to students majoring in Plastics Engineering Technology.

DO NOT COMPLETE THIS APPLICATION UNLESS YOU HAVE A PARENT WHO WORKS AT ERIE PLASTICS.

First Name:  Mid Init: 

Last Name:   

PSU ID: 

Email:

Home/Permanent Address 1 :

Home/Permanent Address 2:

City:   State:   Zip:

Current or intended major:

Name of Family Member Employed by Erie Plastics, Inc or one of its successor companies: 

Relationship to Student:

RELEASE STATEMENT:

In accordance with the Family Rights and Privacy Act of 1974, I hereby authorize the Financial Aid Office at Penn State Behrend to release the information contained on this application, in addition to grade point average, to representatives of the organization sponsoring the scholarship and members of the scholarship committee for use in evaluating scholarship applicants.

I understand that scholarship awards may be adjusted or revoked due to unsatisfactory academic progress, change in enrollment status, ceased enrollment at Penn State Behrend, or otherwise failing to meet the guidelines of the awarded scholarship.

SUBMIT THIS APPLICATION BY FEBRUARY 1, 2008.

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