2021 Certification Accelerator Scholarship
Complete this form and email to your chapter at paul.jackson@nationalgird.com by 1 October 2020.
Applicant Information:
Name:
ASIS ID #:
Address:
City/State/Zip:
Phone:
Email:
Employer:
Job Title:
# years as ASIS Member:
# years in Security Profession:
I am interested in this certification: ___CPP ___PSP ___PCI ___APP
I plan to apply for the certification exam on or around this date: ____________________ (Note: you will have two years to take the exam after approval of your application.)
Community Information (Please indicate if you are a Community Member, e.g. Women in Security, Young Professional, etc.)
Council/Chapter Membership:
Officer Name:
Officer Title:
Phone:
Email:
Please tell us about yourself: (Limit your answer to 500 words or less.)
Signature: _________________________________________________________ Date: ______________
Subject to the ASIS Foundation stated scholarship criteria, winning applicants will be selected on an objective and
non-discriminatory basis, without regard to race, age, gender, religion, political beliefs, employment status, or any other factors that constitute unfair or illegal discrimination.
Application materials should be emailed directly to your chapter at paul.jackson@nationalgrid.com
1625 Prince Street
Alexandria, VA 22314-2882 USA
+1.703.519.6200
Fax: +1.703.519.6299
www.asisfoundation.org
Complete this form and email to your chapter at paul.jackson@nationalgird.com by 1 October 2020.
Applicant Information:
Name:
ASIS ID #:
Address:
City/State/Zip:
Phone:
Email:
Employer:
Job Title:
# years as ASIS Member:
# years in Security Profession:
I am interested in this certification: ___CPP ___PSP ___PCI ___APP
I plan to apply for the certification exam on or around this date: ____________________ (Note: you will have two years to take the exam after approval of your application.)
Community Information (Please indicate if you are a Community Member, e.g. Women in Security, Young Professional, etc.)
Council/Chapter Membership:
Officer Name:
Officer Title:
Phone:
Email:
Please tell us about yourself: (Limit your answer to 500 words or less.)
- Describe your professional accomplishments and explain why you are a strong candidate for this scholarship.
- Describe how this ASIS certification will benefit you and help you achieve your career goals, including how you will apply this knowledge in your profession and/or mentor others.
- Describe your involvement, leadership and/or activities in your Chapter.
Signature: _________________________________________________________ Date: ______________
Subject to the ASIS Foundation stated scholarship criteria, winning applicants will be selected on an objective and
non-discriminatory basis, without regard to race, age, gender, religion, political beliefs, employment status, or any other factors that constitute unfair or illegal discrimination.
Application materials should be emailed directly to your chapter at paul.jackson@nationalgrid.com
1625 Prince Street
Alexandria, VA 22314-2882 USA
+1.703.519.6200
Fax: +1.703.519.6299
www.asisfoundation.org