SEIRFHG COLLEGE SCHOLARSHIP PROGRAM

2023-2024 APPLICATION

2023-24 SEIRFHG College Scholarship Application

Overview:

The Southeast Iowa Regional Fire Honor Guard (SEIRFHG) believes that high school students furthering their education are a vital component of the academic experience. In support of that belief, the SEIRFHG annually sponsors a College Scholarship Program to reward students who succeed in the classroom while balancing a commitment to Fire, EMS, Law Enforcement and or Tele – Communication.

The SEIRFHG will grant two $250 scholarships. Scholarships are awarded on an annual basis. The SEIRFHG College Scholarship Program Selection Committee determines the two recipients after reviewing all the applications.

Eligibility:

To be eligible for an SEIRFHG College Scholarship, students must meet all the following criteria:

Be a graduating senior and member of an Emergency Response (Fire EMS Law Enforcement agency)

Have maintained a minimum high school GPA of 3.0,

Intend to enroll full-time in a two or four-year credited college/university beginning the following fall term,

Have submitted a complete application prior to the deadline of April 1, 2024.

If after you are awarded the Scholarship and for any reason you decide not to attend College, the Scholarship must be returned.

To Apply:

Applications must be completed fully. Please use the checklist below to ensure that you have completed all of the necessary requirements:

Personal Information & School History

One Brief Essay

Application Statement & Signature Sheet

Verification Page (GPA and Fire, EMS, Law Enforcement)

Postmarked by April 1, 2024.

Please mail completed application to:

Southeast Iowa Regional Fire Honor Guard

ATTN: Heidi Grunwald

1010 Grand Park Dr

Fairfield, IA 52556

OR Scan and send to seirfirehonorguard@gmail.com

2023-24 SEIRFHG College Scholarship Application

Personal Information

Full Name:

Home Address:

Mailing Address:

(If different)

Home Phone #:

Birthdate

Gender:

Please circle Male Female

School History

School Currently

Attending:

Dates Attended: __________________ to _______________________

Cumulative GPA:

Number of months, or years of participation in: Fire, EMS, Law Enforcement

Other Schools Attended (if any):

Dates Attended: __________________ to _______________________

Cumulative GPA:

2023-24 SEIRFHG College Scholarship Application

Essay Question:

Please complete the following essay question. Response should be typed, double spaced, and submitted on plain white paper. Please limit your response to the length indicated.

Describe how your experience in Fire, EMS, Law Enforcement has contributed to your personal development. (300 – 500 words)
2023-24 SEIRFG College Scholarship Application

Verification of GPA and Emergency Services Participation

GPA

My most recently computed GPA is _______________________.

Attach a current copy of your transcripts or have a school official (guidance counselor, high school principal or superintendent) verify your GPA by signing the statement listed below.

I hereby certified and attest that ____________________________________ carries the above referenced GPA.

______________________________________________	_______________

School Official (Title)	Date

EMERGENCY SERVICES FIRE EMS LAW ENFORCEMENT TELE COMMUNICATIONS

A member on the Command Staff must verify your participation in your department.

I hereby certify and attest that ___________________________________ has participated in Fire EMS and or Law Enforcement.

________________________________________	________________________

Command Staff (Title) Date

2023-24 SEIRFHG College Scholarship Application

Please print, sign and mail this form with all of your other application materials (i.e. personal information sheet and essay question).

Application Statement & Signature:

All information in this application is true, accurate, and complete to the best of my knowledge. I understand and agree that misrepresentation or omission of facts in my application will justify elimination from consideration for a scholarship. I hereby authorize the SEIRFHG College Scholarship Selection Committee to verify any information I submit.

____________________________________________________ ___________________

Signature	Date

____________________________________________________	____________________

Print Name	Date of Birth