SCHOOL NUTRITION ASSOCIATION OF VIRGINIA

Application For the

Helen G. Ward Scholarship

Deadline for Application - February 1, 2009

NAME _____________________________________MEMBERSHIP #______________

HOME ADDRESS________________________________________________________

YEARS MEMBERSHIP IN SNA OF VA _____PRESENT JOB TITLE_____________

WHAT COURSE WAS OR WILL BE TAKEN? ________________________________

LENGTH OF COURSE _________________________COST OF COURSE__________

GIVE NAME OF INSTITUTION ____________________________________________

WILL YOU CONTINUE TO WORK FOR SCHOOL FOOD SERVICE IN VIRGINIA

UNTIL AT LEAST MARCH, 2009?                        _____ YES, _____ NO

LIST THE NAME OF YOUR IMMEDIATE SUPERVISOR WHO IS FAMILIAR WITH YOUR PRESENT FIELD OF WORK:

                        Name                                                   Address                                   Zip

_____________________________________________________________________

SIGNATURE ____________________________________________DATE __________

IN ORDER TO BE CONSIDERED FOR A SCHOLARSHIP BASED ON SNA-VA BYLAWS, INCLUDE A DETAILED WRITTEN REASON FOR APPLYING AND THE PURPOSE OF PURSUING EDUCATION IN THE FIELD OF SCHOOL FOOD AND NUTRITION.  APPLICATION WILL NOT BE CONSIDERED WITHOUT THIS INFORMATION ATTACHED.

(Form May Be Copied)

Submit to:             Sandra Stokes

                        SNA-VA Scholarship Chairman

                        7610 Whitepine Road

                        Richmond , VA 23237