Robert E. White Memorial Scholarship Application

Please fill out all required fields and submit any supporting documents.

Robert E. White Memorial Scholarship Application

*Applicant Name (or contact person for non-profit organization)*

*Are you or your Fire Chief a VFCA member? One of you must be a member to apply for the scholarship!*

*Date of Birth*

*Email address*

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*Address, City, State, Zip*

*Phone Number*

*Firefighter Name (applicant or applican't parent/spouse)*

*Department Name*

*Department Address, City, State, Zip*

*Department Chief*

*Department Phone*

*Course/Class/Seminar/Program Information (include title)*

*Start date*

*End date*

*Location*

*Contact name and phone number*

*Please attach a statement indicating your background, educational goals, why you believe this educational program will be useful to you & why you are applying for financial assistance.*

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*Itemize any direct costs which can include: registration, travel, meals, books, tuition, lodging and transportation.*

*Please upload any other information that you think would be important for our scholarship review team. *

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Submit