ICU Foundation Online Application

ICU Foundation Group Scholarship Application

1. Credit Union/Chapter

2. Total Number of Participants

3. Asset Size of CU

OR: Participating CUs with less than $5M in assets

None
1 - 24%
25 - 49%
51 - 74%
75 - 100%

5. Type of scholarship (select one)

ICU System training (League education session, conference, webinar)
Certification Course
Self Study Course (STAR/VAP/VLP/MERIT)
Other

6. Dollar amount requested

7. Course title and date of program

8. Please detail cost of program below (specify registration fees, transportation & lodging, materials, etc.):

9. Will participants use personal time while receiving this training?

Yes
No

10. Will the chapter or credit union help pay tuition/expenses?

Yes
No

If yes, how much is covered?

11. Have you ever applied for an ICU Foundation Scholarship?

Yes
No

Received one?

Yes
No

12. Please explain how this educational program will benefit your credit union(s):

13. Please indicate extenuating circumstances relevant to this application:

14. Please list the participants, their credit union affiliation and indicate staff of volunteer:

Please see Web site or printable applcation form for details regarding scholarship eligibility requirements. Thank you for your submission.

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