Ruth Wright Scholarship Application

Please attach a page to this application and fill in the necessary information.

Name:

Home Address:

City, State, Zip:

Home County:
(ex. Cook, Will, McHenry)

Phone:

E-mail:

Fax:

On separate sheets of paper:

List past positions/responsibilities held that related to the education of gifted children.
Describe your current position and responsibilities.
Please provide a brief statement describing how your participation in the IAGC Convention would benefit the gifted community.
Application deadline is October 15.

Please provide two references that we may contact regarding your scholarship request.

Name:

Phone:

Position:

Name:

Phone:

Position:

The enclosed information which I have provided as part of this application is accurate to the best of my knowledge.

__________________________________    _____________________
           Signature                          Date

Return form to:
IAGC Recognition Committee
Attn: Nancy Heaton
800 E. Northwest Hwy., Suite 610
Palatine IL 60074

Name:
Home Address:
City, State, Zip:
Home County: (ex. Cook, Will, McHenry)
Phone:
E-mail:
Fax: