
(PLEASE PRINT)
Name_____________________________________________________________________________
Home Address______________________________________________________________________
City_________________________________________State______Zip Code____________________
Home Email________________________________________________________________________
Home Phone_____________________________ Cell Phone_________________________________
School Name ______________________________________________________________________
School Phone Number_______________________________________________________________
School Email_______________________________________________________________________
Please check the ONE scholarship choice being applied for:
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Rank II (Master’s degree) o Rank I (beyond Master’s degree)
oClassified to the Classroom o National Board Certification (NBCT)
ALL APPLICANTS MUST:
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Be a BCEA member
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Provide proof of enrollment in a continuing education program. [Appropriate example of proof would be: copy of a transcript, receipt of tuition payment on institution letterhead (easily obtained online), current course schedule]
• Scholarships will be awarded by random drawing. One Scholarship per school year per person only.
Winter 2021:
o Four (4) $500 Scholarships for Rank III seeking Rank II, Rank II seeking Rank I or for NBPTS (National Board) Certification
• Deadline for Fall 2022 Application is due by 4 PM on Monday, October 3, 2022.
• NO email applications accepted
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Please submit application and proof of enrollment by pony to: Kelly Read c/o BCEA at Central Office or mail directly to:
Boone County Education Association
75 Cavalier Blvd. Suite 324
Florence, KY 41042-3963
