1199 Joseph Tauber Application Form – Fill Out and Use This PDF

Attending College in Academic Year 2014 - 2015? Request the Joseph Tauber Scholarship Application

The Joseph Tauber Scholarship Program provides scholarships to children of eligible 1199SEIU members who are attending accredited undergraduate programs. Eligible members are those whose employers contribute to the National Beneit Fund or the Greater New York Child Care Fund. Members must have received Wage Class I beneits for at least one year. Candidates must be high school graduates, post-secondary school students, or previous

awardees enrolled full time for a minimum of 12 college credits each semester. All candidates must be younger than 23 years of age by the start of the Fall 2014 semester. Previous awardees seeking scholarship support should note that automatic award renewals are not granted;

you must reapply each year for consideration.

To request an application to the Joseph Tauber Scholarship Program, complete the application request form below and submit it before January 31, 2014. You may only submit one application request form per child. If both parents are 1199SEIU employees, choose one parent to submit on behalf of the child. If you need additional forms, you may download them by visiting our website at www.1199SEIUBeneits.org/ccf during the application request period. Please note that this application request form is NOT an actual application; it is valid for the 2014-2015 award year only.

Fax your completed request form to (646) 473-6949 or mail it to the 1199SEIU Child Care Corporation, Joseph Tauber Scholarship Program, 330 West 42nd Street, 18th Floor, New York, NY 10036-6977. Once you submit the form as instructed, if eligible, you will be sent a Scholarship Application Kit in March. The Kit includes several forms that must be completed and returned per the speciic instructions and by the dates indicated, in order for consideration.

Scholarship award amounts vary according to need, with a yearly minimum award of $750. WhileJosephTauberScholarshipscansupporteligiblestudents in any ield of study, the 1199SEIU Next Generation RN Scholarship program provides inancial and academic assistance to children of 1199SEIU members in the clinical phase of a nursing program. To ind out if your child qualiies, or if you have any questions, please call (646) 473-8999.

JOSEPH TAUBER SCHOLARSHIP PROGRAM • 2014-2015 APPLICATION REQUEST FORM

Student Information (please print clearly)

Student Name __________________________________________________________________________________

First NameLast NameDate of BirthCurrent Age

E-mail Address _________________________________________________________________________________

Date graduated from, or expected to graduate from high school __________________ College Entrance Date _____________________

First-time Joseph Tauber Scholarship Program applicant? Yes		No

Member Information (please print clearly)

Member Name _________________________________________________________________________________

First NameLast NameMember ID No.

Home Phone ____________________________________ Cellular Phone ____________________________________

Address ________________________________________________ City _____________ State ____ Zip __________

E-mail Address _________________________________________________________________________________

National Beneit Fund (NBF)		Greater New York Child Care Fund		NBF Rochester-Area Members		LPN Welfare Fund

Your application request form must be received by the Scholarship department before January 31, 2014 in order for us to send you an oficial Scholarship Application Kit. If you have not received your Scholarship Application Kit by April 1, 2014, please call us so that we can assist you.