Ted Brickley and Bernice Shikora Scholarship

    Are you enrolled in an accredited University majoring in a related EHS major?
    YesNo

    Are you a full time or part time undergraduate or graduate?
    YesNo

    Do you have a GPA between 2.50 – 4.00?
    YesNo

    Do you have a GPA above a 3.0 in environmental or safety courses on a 4.0 scale?
    YesNo

    Are you a New Jersey resident or attend a college in the State of New Jersey?
    YesNo

    Applicant Information
    Full Name:

    Street Address:

    City/Town:

    State:

    Zip Code:

    E-mail Address:

    Phone Number:

    Education
    Name of college/university:

    GPA:

    Major:

    Organizations involved with:

    Class Standing: (by credits)
    FreshmanSophomoreJuniorSeniorGraduate

    Experience
    Are you currently employed?
    YesNo

    Describe your role and experiences gained for your work experienced:

    Describe your extracurricular activities such as volunteer work:

    Further Requirements

    Submit a brief biography about your interest, hobbies, and/or work experience

    Submit a copy of your current transcript

    Submit a reference letter from a high school teacher, University Professor, University Department Head, or Supervisor at a current job