ࡱ> QSPY  bjbjWW T==p[]TdNb& d- 4=`$J>a s a a  b a 4=a =  =B@=Nq@+^ =APPLICATION FOR CIVIL AIR PATROL SCHOLARSHIPS Important: This application must be complete before it will be accepted for considerations. (Refer to CAP Pamphlet 53.1 for detailed information on scholarships. Refer also to checklist on page 4 of this application.)TO: NATIONAL HEADQUARTERS CAP (TT) MAXWELL AIR FORCE BASE, ALABAMA 36112-5572PHOTOTO BE COMPLETED BY APPLICANTLAST NAME - FIRST NAME - INITIAL  FORMTEXT        FORMTEXT        FORMTEXT  HOME ADDRESS (Street Number, City, State, Zip Code)  FORMTEXT      CAP SERIAL NUMBER  FORMTEXT      DATE JOINED CAP  FORMTEXT      MEMBERSHIP CATEGORY  FORMTEXT      DATE OF BIRTH  FORMTEXT      UNIT  FORMTEXT      WING  FORMTEXT    DATE MITCHELL AWARD ISSUED  FORMTEXT      WING THAT ISSUED MITCHELL AWARD  FORMTEXT    SCHOLARSHIP APPLIED FOR  FORMCHECKBOX  Undergraduate  FORMCHECKBOX  Adv Undergraduate  FORMCHECKBOX  Graduate  FORMCHECKBOX  Tech-Voc  FORMCHECKBOX  Flight  FORMCHECKBOX  Other  FORMTEXT       Field OF STUDY  FORMCHECKBOX  Engineering  FORMCHECKBOX  Science  FORMCHECKBOX  Education  FORMCHECKBOX  Humanities  FORMCHECKBOX  Other  FORMTEXT       (Specify)GRADE POINT AVERAGE (if known) MAXIMUM POSSIBLE  FORMTEXT        FORMTEXT      NAME OF SCHOLARSHIP APPLIED FOR (if applicable)  FORMTEXT      1. SYNOPSIS OF CIVIL AIR PATROL ACTIVITYCHRONOLOGICAL LISTING OF ALL CAP COMMAND AND UNIT POSITIONS HELD:  FORMTEXT      CAP 95 Previous editions may be used PAGE 1 OF 4 PAGES C: LIST ALL CAP SPECIAL ACTIVITIES, ENCAMPMENTS, HONORS, ETC.  FORMTEXT      II. SYNOPSIS OF HIGH SCHOOL AND COLLEGE ACTIVITIES (List chronologically memberships, offices held, honors, sports, other)  FORMTEXT      III. SYNOPSIS OF AL OTHER ACTIVITIES (List chronologically all social, community, church, and other non-CAP, non-scholastic activities)  FORMTEXT      CAP 95 PAGE 2 OF 4 PAGES. IV. NARRATIVE STATEMENT (State in one paragraph why you think you should be awarded the scholarship applied for.)  FORMTEXT      IMPORTANT: See reverse for lists of supporting documents which must be attached. If the required material is not attached, the application will be returned. I certify that the information provided in this application is complete and correct. I understand that my application must be fully completed, with the required supporting documents attached, before it will be accepted for consideration. Date Signature of Applicant TO BE COMPLETED BY UNIT COMMANDERI certify that the above information is correct to the best of my knowledge and belief. I recommend the applicant for CAP scholarship consider- ation. Date Signature of Unit Commander TO BE COMPLETED BY WING COMMANDERThe above-named applicant is approved as a candidate of the  FORMTEXT    Wing for Civil Air patrol scholarship consideration. Date Signature of Wing Commander CAP 95 PAGE 3 OF 4 PAGES. CHECKLISTS FOR SUPPORTING MATERIAL Check the block in front of each item in the appropriate checklist when the material is obtained. All supporting material listed for the applicable scholarship category must be attached to the application before it is submitted. If all supporting data are not attached, the application will not be considered. Additional material may be submitted if desired.UNDERGRADUATE ( TRANSCRIPT OF HIGH SCHOOL CREDITS, PLUS TRANSCRIPT OF COLLEGE CREDITS, IF APPLICABLE ( SCORES OBTAINED ON COLLEGE ENTRANCE EXAMINATION. ( STATEMENT OF ACCEPTANCE FROM AN ACCREDITED COLLEGE OR UNIVERSITY (OR CERTIFICATE THAT APPLICATION HAS BEEN MADE). ( RECENT PHOTO ATTACHED TO TOP RIGHT CORNER OF CAPF 95. ADVANCED GRADUATE ( DOCUMENTS TO SUBSTANTIATE ACTIVE PARTICIPATION IN CAP FOR PRECEDING 3 YEARS. ( TRANSCRIPT OF COLLEGE CREDITS. ( RECENT PHOTO ATTACHED TO TOP RIGHT CORNER OF CAPF 95. GRADUATE ( DOCUMENTS TO SUBSTANTIATE ACTIVE PARTICIPATION IN CAP FOR PRECEDING 3 YEARS. ( TRANSCRIPT OF COLLEGE CREDITS. ( STATEMENT OF ACCEPTANCE FROM GRADUATE SCHOOL TO BE ATTENDED. ( RECENT PHOTO ATTACHED TO TOP RIGHT CORNER OF CAPF 95. TECHNICAL-VOCATIONAL ( TRANSCRIPT OF HIGH SCHOOL CREDITS. ( STATEMENT OF ACCEPTANCE FROM AN ACCREDITED TECHNICAL-VOCATIONAL (OR CERTIFICATE THAT APPLICATION HAS BEEN MADE). ( RECENT PHOTO ATTACHED TO TOP RIGHT CORNER OF CAPF 95. DAEDALIAN FLIGHT SCHOLARSHIP ( TRANSCRIPT OF HIGH SCHOOL CREDITS, ( SCORES OBTAINED ON COLLEGE ENTRANCE EXAMINATION. ( STATEMENT OF ACCEPTANCE FROM AN ACCREDITED COLLEGE OR UNIVERSITY. ( FAA MEDICAL CERTIFICATE. ( RECENT PHOTO ATTACHED TO TOP RIGHT CORNER OF CAPF 95. CAP 95 PAGE 4 OF 4 PAGES. 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