1. Healthcare

“George Webster Memorial State Scholarship Program”
Application for Educational Assistance
(Complete all questions; incomplete answers may disqualify an application)
Applicant’s Name: ______________________________________________________
First
Middle Initial
Last
Home Address: _________________________________________________________
Street Address
_________________________________________________________
City
State
Zip
Home Phone: _____________________ Work or Cellular: ____________________
School and District: ______________________ County: ______________________
Date of Birth: _____________________ Place of Birth: _______________________
Month/Day/Year
City/State
Lodge President: _____________________ Lodge Number: ______ District _____
Lodge Address: ___________________________________________
___________________________________________
___________________________________________
District Director: _________________________________________
Parent’s Law Enforcement Agency: _______________________________________
Agency Name
Agency Address: ________________________________________________________
City
State
Zip
Father’s Name: ____________________________________ Living: ( ) Yes ( ) No
Mother’s Name: ____________________________________ Living: ( ) Yes ( ) No
Sponsor’s Name (if not same as above): __________________________________________
Revised 09/2014
Fraternal Order of Police
George Webster Memorial Scholarship
Have you made application to a college or university? ( ) Yes ( )No
Have you been accepted to a college or university?
( ) Yes ( ) No
Name of the College or University: ________________________
In 200 words or more, tell about yourself and include (if applicable) school and
community activities in which you have participated. List any offices or positions held,
any special recognition received while participating in school and include community
activities. Describe your future goals after completing college.
Rank in Class: _________ of _______
Grade Point Average: ___________
Attach most recent certified copy of your high school or college transcript (if enrolled).
I hereby certify the above is true, correct and complete.
_______________________________________
Applicant’s Signature
_________________
Date
Sworn to and subscribed before me this
__________ day of ________________, 20_____
_________________________________
My Commission Expires: ___________
Notary Public
Certification of Lodge that applicant is the dependent son or daughter (grandson or
granddaughter) of a member in good standing:
Certified by Lodge: _______________________________ Lodge # _________
Lodge President or designee signature: __________________________________
Title or Board Position: ______________________________________________
Revised 09/2014
“Fraternal Order of Police
George Webster Memorial State Scholarship Program”
Scholarship Rules and Regulations
1. The “Fraternal Order of Police George Webster Memorial State Scholarship” will be awarded to
one qualified recipient per calendar year and will be good for 4 years. It is intended to assist the
recipient by providing a scholarship award of $2,000.00 annually, which will be made payable to
both the recipient and the accredited college, university or other educational institution of the
scholarship recipient’s choice, recognized by the U.S. Department of Education Database of
Accredited Postsecondary Institutions and Programs.
2. The recipient must be the dependent son or daughter, grandson or granddaughter of a
Fraternal Order of Police member in good standing, at the time of application, of a subordinate
lodge of the Florida State Lodge, Fraternal Order of Police.
3. The scholarship will be awarded on the basis of scholastic achievement, academic load and
community involvement and prior work history if applicable.
4. The Scholarship Committee shall be composed of seven members; the chairperson and a
representative from each of the remaining six ﴾6﴿ districts. The Scholarship Committee will meet
and review all applications at the February Board Meeting of the Florida State Lodge and
additional time if necessary will be allotted at the Law Enforcement Officer’s Memorial in
Tallahassee in May. An alternate winner may also be chosen from the remaining applicants and
will receive a non-renewable scholarship of $2,000.00. The committee shall disperse two (2)
additional non-renewable $1,000.00 scholarships to two (2) qualifying applicants (The Tony
Fontana Lifetime Achievement Scholarship and the Donald E. Merritt Spirit of Fraternalism
Scholarship) and one (1) non-renewable $500.00 scholarship (the Lonnie Miller, Sr. Scholarship).
The decisions of the Scholarship Committee are final.
.
5. The applicant shall submit their application to the respective sponsor’s local lodge president or
if unavailable, another member of the local lodge board for certification of the application. The
local lodge will have all completed, notarized applications mailed to the Florida State Lodge in
Tallahassee, postmarked by February 1, 2015 to the attention of the State Scholarship
Committee. The Scholarship committee will not accept any applications postmarked after
February 1, 2015.
6. The scholarship winner and alternate winners will receive notice of the scholarship award by
mail from the State F.O.P. Scholarship Chairperson. All recipients will receive their scholarships
at the June Conference, (location to be announced each year). The winner should fully
understand that in accepting this scholarship:
A.
B.
The applicant meets all requirements to enter and attend the college or university and
An overall 2.50 grade point average must be maintained during each semester
Revised 09/2014
C.
The applicant must apply and be accepted or already be enrolled in an accredited
college or university.
D. Each year, a renewal application must be completed and submitted, along with a current
st
certified transcript, in order for the scholarship to continue by June 1 postmark.
7. Only those applications marked “rev 09/2014” will be accepted.
8. Any deviation from the applicant’s original application is subject to review by the scholarship
committee. The Scholarship Committee decision will be final.
9. These rules are subject to revision each year, as provided by the Florida State Lodge
Constitution and By-Laws.
Revised 09/2014