Chief Petty Officer Scholarship Fund Application Form “You are eligible to apply for the CPO Scholarship ONLY if your sponsor achieved the rank of Chief Petty Officer in the United States Navy. Furthermore, your sponsor must be currently serving on Active duty or Reserve duty, or must have been honorably discharged, transferred to Fleet Reserve status, or Retired from the Naval Service 1s a Chief, Senior Chief, or Master Chief Petty Officer. Applicant’s Name: SHUAWIE Harv: Address 1: 10) ise Drive Address 2: Vili city: VITA Beacon state: VY zip code: _22A5% Phone No.: (197). 264-2674 email: Shyanne. Narvey \4@ yahoo.com Sponsors Name: Joviatnar Weov) Sponsor: \_ Living __Deceased Sponsor's Address (if different from above): SUVVIf US alooue City: State: Zip Code: ‘APO/FPO Address If Sponsor Deployed/Forward Deployed: Ship/Home Port: Country: ‘APO/FPO Address: Zip Code: Sponsor's email address: \nnathar 1M. wood @ Navy. Phone No.: 157-42) - 8654 Sponsor's status: Y_ Active Duty ___Retired __ Reserve ___ Fleet Reserve ___ Medically Retired sponsor's rank: X Chief __ Senior Chief __ Master Chief Applicant's Relationship to Sponsor: Jk dav ew Note: If the Sponsor is deceased, please annotate last duty station for address.Current High School or College/University Address: Name of School: (aside +hidh Khoel Address1: H1W0_taugood Youd Address 2: LAL city: NavOid Bean state: VY zip code: 23455 _ country: \VS¥¥ Class standing (if available): _21_| 34 i Received (please specify hi lege, or communi _ Honors & Awards High School, College or Community | Honor vou aligin Sonoo! SVartsman snip Award igh Senco! Comers Ruiard (Sortloall ) ‘tian Sunoo\ Extracurricular Activities it choo! or Coll Activities High School or College SUA Aid Suneo! [Educators Wicing, _ ign Suneol | S0r toa) eames i Na Stneo! ai Gross COUN er, LUASS (Wo! han cant Tak and Ficid it ies/Involvement Jamaicd Mission Try Puey tO B60 Mission Tp. [HS Ftshman Onentation [Came Puddl ph (edi: vhotodrmpner Harner dnt Wale meratron |oe Live Mission Meal Packaging, nh NOs a4 Waration pilot Sunwol : Groupe leader Attach additional sheets if neededName and Address of two personal references (not relatives) Name: Wea _Manao Address 1: H4¥0_ Horgan voos| Address 2: citys NOAM eau state: VA ip Code: 234453 Phone No.: 15) -v'46.200 Name: Puan Lott Address 1: 5424 Yavhament Drwe Address 2: city: Mivarnid beac state: A zip code: 23402. phone No.: 197-0. 2925 Letters of Recommendation: Include three (3) letters of recommendation. Letters must be signed and should be typed or neatly hand written on unlined paper in blue or black ink. At least one letter should be from someone other than a teacher, counselor, or administrator who can provide non-academic insight on the applicant. Letters e-mailed separately from this application will not be accepted. Dependent’s ID Cards: Provide a photo copy of the front of your dependent’s ID card with your application. Should you not be able to provide 2 copy of your ID card, please provide a photo copy of Page 1 of your Sponsors most recent DD-214, Personal Statement: Please attach a 200-500 word autobiographical essay in which you discuss significant experiences, community involvement, and the qualities of character and leadership important in achieving your goals. Highlight those personal accomplishments, achievements, and experiences that have given you considerable satisfaction and have helped you form your character. Be sure to comment on your aspirations in terms of your education and career goals. Finally, explain the significance that recelving a scholarship would mean in your life. Personal statements are used by the scholarship committee to help select scholarship recipients. Be sure to include your name on your personal statement Certification: | affirm that the information provided on this CPO Scholarship Fund Application is accurate and true to the best of my knowledge pursuant to the Family Educational Rights and Privacy Act of 1974, as amended (FERPA). Thereby authorize the CPO Scholarship Fund to release scholarship application information provided by me as well as other official and unofficial information such as my academic progress and status. | authorize permission for the CPO Scholarship Fund to contact academic institutions for release of transcripts and any‘other information required for verification of submitted materials. | also understand that awards can be denied based on false or misleading statements. Applicant's Signature: —2+wevrWk Hadsaettrcte Date: 2) 23) |v | affirm that to the best of my knowledge the, this scholarship can be denied based on fal Wve information is accurate and correct. | also understand that isleading statements. PO Sponsor/Guardian Signatu pate: 24 FS Note: Applications post marked after 1 April, 2016 will NOT be considered! Mail completed application package t Senior Enlisted Academy Alumni Association C/O The CPO Scholarship Fund 1269 Elliot Avenue Newport, RI 02841-1525