The Engineers Club of Kansas City, acting through its Student Assistance Committee (SAC), exists to assist deserving students from the greater Kansas City area in obtaining an engineering education. These funds are normally limited to $500-$2,000 per year and assistance are awarded for one year without guarantee of continuance. Any applicant, however can apply for renewal annually.

The recipient of a scholarship from the Engineers Club of Kansas City agrees to comply with the following conditions:

1. To restrict expenditures to a reasonable minimum in accordance with the applicant’s claim of limited means.

2. To give concrete evidence of financial need by the earning of as large a part of his/her expenses as possible when and if scholastic requirements will permit.

3. To give concrete evidence that the student is acting in good faith in planning to graduate with an engineering degree from an accredited engineering college.

4. To commit no acts reflecting poorly upon the applicant’s good moral character.

5. To use the scholarship funds only for the purposes intended, and to keep the SAC advised as to progress, scholastic term reports, and needs.

6. To make a contribution to the Student Assistance Program after graduation to assure the program’s continued effectiveness and as a gesture of appreciation.

Applications for student assistance can be obtained by request from the SAC Chair, or often from area high school guidance counselors and financial aid offices of area universities (Kansas & Missouri) with accredited schools of engineering. Once applications are received, students will be assigned a sponsor from the SAC. This sponsor will interview the applicant at which time the student will be asked to discuss plans for education, including his/her choice of engineering discipline, financial need, plan for financing of education and other items which are used for the evaluation of applicants. The SAC sponsor is an active member of the Kansas City engineering community, and is also available as a sounding board for student’s questions about the field of engineering. Often, due to experience gained through participation with the SAC, the sponsor can be of great assistance in providing insight towards the pursuit of an engineering degree, average costs of college, etc.

The acceptance of an application does not imply any obligation on the part of the Engineers Club of Kansas City or the SAC. All information given in the application will be considered confidential. No publicity as to the amount of any grant-in-aid will be permitted.

The deadline for applications to be received or post marked by the SAC is June 15th. Other information required includes: (1) your high school transcript (if you are a graduating senior preparing to enter college), or (2) your last semester’s grades (if you are currently a student continuing your college education). Please return the completed application to:

Trevor H. Cooke, SAC Chairman

Black & Veatch

8400 Ward Parkway

Kansas City, MO 64111

Office Phone (913) 458-3034

Office Fax (913) 458-3626

e-mail: CookeTH@bv.com

Date:_________________________

Name: Last First Middle			Marital Status: ” Single ” Married
Permanent Home Address: Number & Street City State Zip Code
Current Address: (Only if different from above) Number & Street City State Zip Code
Home Phone: ( ) Current Phone: ( )
E-Mail Address: Date of Birth: / /
Choice of College (in order of preference) or College Attending: a) b) c)
Branch of Engineering (preferred or declared): The upcoming school year will be your: (Circle One) 1^st 2^nd 3^rd 4^th 5^th ___ year in college Estimated Graduation Year / Semester: ________/ Fall Spring Summer (Circle One)		Current Grade Point Average: ACT Score: and/or SAT Score: (required of incoming 1^st year students only)
Note: If already attending college, list activities and honors from that school. High School Attended: Honors Earned in School:
Spare Time Activities:
Father or Guardian: Age: Name: Home Address: Employer’s Name & Address: Position Held:	Mother: Age: Name: Home Address: Employer’s Name & Address: Position Held:
Brothers & Sisters: School (Grade) or Name: Age: Occupation	School (Grade) or Name: Age: Occupation

Parents’ Annual Income (most recent year) Father’s Salary & Wages $ Mother’s Salary & Wages $ Other Income: $ Total Income $ Family Automobiles: Make Year	Parents Assets & Liabilities: Year Mortgage Equity Purchased Home $ $ Cash Value Other Real Estate $ Life Insurance $ Bank Accounts $ Other Investments $ Indebtedness ( Except Mortgage) $
Please use this space to itemize and explain other income and extraordinary expenses. Also explain any special circumstances the committee should know about; for example, divorce or separation, other dependents receiving support from family, illness, special housing problems, other children in college or special school, etc. The financial aspects of these situations should be included. (Attached additional page if necessary.)
Applicant’s Own Assets: List assets which are in the applicant’s own name, such as bank accounts, trust fund or bonds. Indicate any limitations on the use of the asset. Nature of Asset Value Limitations Automobile Owned by Applicant: Make Year
Applicant’s Employment History: List below any jobs held in the past four (4) years. Date Employer Nature of Work Salary $ per $ per $ per $ per
Applicant’s Plans for Summer Employment This Year:

Other Assistance: List below any other assistance applied for (i.e., BEOG, Work/Study,etc.). Give details, including present status, amount granted and any obligations connected therewith. Also include outstanding loans (GSL, NDSL, Engineers Club, etc.). Source Amount Obligations
APPLICANT’S FINANCIAL PLAN FOR SCHOOL YEAR 20____ - 20____
Expenses: Tuition & Fees $ Books & Supplies $ Room & Board $ Transportation $ Clothing $ Other $ $ $ TOTAL $	Resources: Assistance from parents $ Student’s summer earnings $ Student’s earnings at college $ Student’s assets $ Other Assistance (Please Specify) $ $ $ TOTAL $
THIS APPLICATION IS FOR A ý GRANT Amount: $ N/A
I certify that: The information contained in this applications is complete and accurate. I will use any assistance given me only for the purpose of furthering my engineering education. I will conduct myself as a responsible scholar and apply myself industriously to my studies and scholastic opportunities. I will refrain from any activity which might bring disrespect on myself, my family, my school, my community or the Engineers Club of Kansas City. Upon graduation, I will endeavor to assist other students as I hope to be helped. Please attach copies of past semester grades. Applications may not be processed without this information. Date: Student Signature:
Parents’ Verification: We have checked this application for omissions and errors. To the best of our knowledge, the information reported is complete and correct. Date: Parent Signature: Date: Parent Signature: