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William “Sully” Sullivan Scholarship Application Form

William “Sully” Sullivan Scholarship Application Form

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Checklist of Required Documentation

Must be an employee enrolled in a vocational school, college, or university (full or part time).
Must be an employee at a VPPPA full-member site who has made significant on-site contributions to the VPP program.
Provide a reference letter relating to your on-site VPP involvement from a VPP coordinator, operations manager, site EHS staff, OSHA, Regional VPPPA Chapter Chairperson, etc.
Provide an official copy of your current transcript.
Provide a typed biography or current resume. Please include examples of contributions to VPP at your site.

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Personal Information

Applicant Name *

Date

Phone *

Email *

Home Address *

Address Line 1

City

State

Zip Code

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VPPPA Information

VPPPA Member's Name *

Relationship to Candidate *

VPPPA Member Site *

Member ID# *

Phone *

Email *

Member's Address *

Address Line 1

City

State

Zip Code

Section Divider 2

Academic Information

Name of Institution *

Student ID Number *

Address of Institution *

Address Line 1

City

State

Zip Code

Address of Financial Aid Office *

Address Line 1

City

State

Zip Code

^† Scholarship winners will have their award sent directly to the institution’s financial aid office.

Class Standing *

What course of studies are you enrolled/enrolling in? *

GPA *

Yes, my GPA is at least 2.5 on a 4.0 scale

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Supporting Documentation

Briefly explain your contributions to the VPP program at your site. *

(You may upload any supporting documents in the section below.)

Please attach the following:

An official copy of your current transcript
A reference letter from the VPPPA site employee (if applicable) to which you are related
A reference letter from a high school teacher, university department head, professor, or supervisor at your current job
Typed biography or current resume (See above for more details)

File Upload

Click or drag files to this area to upload. You can upload up to 7 files.

(Please do not exceed 10 MB maximum combined file size.)

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