Scholarship Application
Mail all documents together and postmarked by
March 31 to:
CSHEMA, Scholarship Committee
120 W. 7th St., Suite 204
Bloomington, IN 47404
Phone: 812.245.8084
Fax: 812.245.0590
Since 1977, the Campus Safety, Health and Environmental Management Association (CSHEMA) has sponsored the Scholarship Award
Program to encourage the study of safety and environmental management. Currently, one $2,000 scholarship is awarded annually. The program is open to all undergraduate and graduate students in all majors/disciplines, who are currently registered as full-time students in North
America. A full-time student is one who is carrying 12 credit hours per semester, trimester or quarter. Undergraduates and graduate students must have at least one year of study remaining in their degree program. To be considered for the award, students must meet the following requirements: 1) submit an official transcript, 2) complete this application form, 3) write and submit an essay (see Section III). The application, essay and an official transcript (delivered in sealed envelope with university/college seal) must be placed in the same envelope and mailed by March 31 to the address above. Any additional, extraneous materials (photos, resumes, research materials, etc.) will not be considered and will be discarded. The CSHEMA Scholarship Committee will select the recipient. The scholarship, which is dedicated to the memory of Dr. Fay Thompson, will be announced or presented at the annual CSHEMA International Conference.
Section I (Please use an address where you can always receive mail.)
Student Information
Last Name
First Name
Middle Initial
Address
City
State/Province
Zip
Phone
Section II (To be completed by College or University Scholarship Administrator, please print)
College or University Information
School Name
Address
Is the applicant currently registered? (Please submit current transcript)
In