Scholarship Application

Please make sure to review our financial aid page prior to filling out your application, and be aware of the requirements for your application to be considered.

Contact Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Primary Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Education History

Highest Level of Education(Required)

Please specify your Highest Level of Education

Safety or Environmental Professional Certifications held

Safety or Environmental Associations and/or Memberships

Current & Past Employment History (Past 10 Years)

Employment History

Company

Location

Contact Phone Number

Supervisor Name

Please list your employment history for the last 10 years.

Military & Public Service History

Military Service(Required)

U.S. Air Force

U.S. Army

U.S. Coast Guard

U.S. Marine Corps

U.S. Navy

U.S. Space Force

Other

None

Total Number of Years of Military Service

Please enter a number from 0 to 100.

Please specify what other Military Service history you have

Public Service(Required)

Emergency Medical Service

Fire and Rescue Service

Law Enforcement Service

Other

None

Total Number of Years of Public Service

Please enter a number from 0 to 100.

Please specify what other Public Service history you have

Scholarship Information

Which scholarship are you applying for?(Required)

Please make sure to review our financial aid page, and be aware of the requirements for your application to be considered.

Please select which course you'd like to apply this scholarship to(Required)

Which specialist course would you like to apply the scholarship to?

Which other course would you like to apply the scholarship to?

Please tell us why you should be considered for a Scholarship.(Required)

Be specific and describe your current financial situation including family obligations and/or other hardships.

Please include a recent picture for our records.(Required)

Accepted file types: jpg, jpeg, png, Max. file size: 5 MB.

See our available Live and online cOURSES

Mailing Only:

PO Box 3367. Wilmington, NC 28406

Phone:

(800) 922-2219

Scholarship Application

Contact Information

Education History

Current & Past Employment History (Past 10 Years)

Military & Public Service History

Scholarship Information

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