Edward T. Conroy Memorial Scholarship
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- Archibald Harmon
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1 Edward T. Cnry Memrial Schlarship Cntact Infrmatin Edward T. Cnry Memrial Schlarship Prgram prvides financial aid t: Sns and daughters and surviving spuses (wh have nt remarried ) f members f the United States armed frces wh died as a result f military service r wh suffered a service cnnected 100% permanent disability as a result f military service; A veteran wh suffers a service cnnected disability f 25 % r greater as a result f military service and has exhausted r is n lnger eligible fr federal veterans' educatinal benefits; POW/MIA's f the Vietnam Cnflict and their sns and daughters wh were residents f Maryland at the time the persn was declared t be a prisner f war r missing in actin; Sns and daughters and surviving spuses (wh have nt remarried ) f victims f the September 11, 2001, terrrist attacks wh died as a result f the attacks n the Wrld Trade Center in New Yrk City, the attack n the Pentagn in Virginia, r the crash f United Airlines Flight #93 in Pennsylvania; Sn, daughters, r surviving spuses (wh have nt remarried ) f a schl emplyee wh, as a result f an act f vilence either died in the line f duty r sustained an injury in the line f duty that rendered the schl emplyee 100% disabled; Sns, daughters and surviving spuses (wh have nt remarried ) f State r lcal public safety emplyees r vlunteers wh died in the line f duty r wh sustained an injury in the line f duty that rendered the public safety emplyee r vlu nteer 100% disabled; r, State r lcal public safety emplyees r vlunteers wh became 100 % disabled in the line f duty. NOTE: Public safety emplyee r vlunteer must have been a resident f Maryland at the time f death r when declared 100 % disabled. A veteran applicant must have a disability f 25 percent r greater and have exhausted r n lnger be eligible fr federal veterans' educatinal benefits. Applicants, and their parents if dependent, must be residents f Maryland and attend a Maryland pstsecndary institutin. The amunt f the Edward T. Cnry award is tuitin and mandatry fees at the institutin yu attend, but cannt exceed $11,530 fr the academic year. Award amunts may nt reflect subsequent tuitin and fee increases made thrughut the academic year. The ttal dllar amunt f all State schlarship awards may nt exceed yur cst f attendance, as determined by yur schl's financial aid ffice, r $19,000, whichever is less. Awards t the sns, daughters r spuses f victims f the September 11, 2001, terrrist attacks may nt exceed $19,000 when cmbined with any ther schlarships received by a student based n the student's status as a child r spuse f a victim f the September 11, 2001 terrrist attacks.
2 Edward T. Cnry Memrial Schlarship Cntact Infrmatin Awards may be held fr five years f full-time (12 r mre credits per semester) r eight years f part-time (6-11 credits per semester) attendance r a cmbinatin f bth. Recipients may attend at either the undergraduate r the graduate level. Audited curses cannt be used t reach the minimum credits hurs required fr full-time r parttime status. Applicatin Prcess: Initially applicants fr the schlarship must submit the Edward T. Cnry Memrial Schlarship applicatin frm, with all required dcumentatin, and it must be received by July 15, Late applicatins will be cnsidered as lng as funds are available. Selectin: Awards are made annually, with renewal applicants give first pririty. Initial applicants will be awarded based n the pstmarked date f their cmplete applicatin. The award amunt is based upn enrllment status (full-time r part-time), the cst f tuitin and mandatry fees at the institutin the recipient attends, and the number f eligible applicants. Late applicatins will be accepted; hwever, awards will nly be made n the basis f available funds. NOTE: Awards are subject t the availability f funds. Return applicatin by: MAIL FAX IN-PERSON Twsn University Financial Aid Office, Schlarship Unit 8000 Yrk Rad Twsn, MD Schlarship Unit Enrllment Services Center Rm 305 schlarship@twsn.edu
3 Edward T. Cnry Memrial Schlarship Cntact Infrmatin EDWARD T. CONROY MEMORIAL SCHOLARSHIP PROGRAM APPLICATION Cmplete and return this frm by July 15, SECTION A - Applicant Infrmatin: (Please Print) 1. TU I.D. Number: Date f birth: / / 2. Last name: First name: MI: Previus name under which recrds may be kept: 3. Permanent mailing address: City: State: Zip cde: 4. Hme phne: Wrk phne: 5. address: 6. Are yu a Maryland resident? Yes N 7. Have yu ever received this schlarship in the past? Yes N Year received: 8. Has smene else in yur family received this schlarship? Yes N 9. Name(s) f persn(s) in yur family wh has/have received this schlarship: 10. Are yu eligible fr the prgram because yu are a sn, daughter, r surviving spuse f a victim f the September 11, 2001 terrrist attacks (deceased died as a result f the attacks n the Wrld Trade Center, the Pentagn r the crash f United Airlines Flight #93)? Yes N SECTION B - Current Cllege/University Infrmatin: 1. Cmplete name f the Maryland institutin yu will attend in academic year: 2. Degree sught: Undergraduate Graduate Anticipated date f graduatin: / / 3. In Fall semester 2018, I will enrll fr: (please put a numeric amunt in the space prvided belw) # f credits_ full-time (12+ credits per semester fr undergraduate; 9+ credits per semester fr graduate student) # f credits part-time (6-11 credits per semester fr undergraduate; 6-8 credits per semester fr graduate student) 4. In Spring semester 2019, I will enrll fr: # f credits full-time (12+ credits per semester fr undergraduate; 9+ credits per semester fr graduate student) # f credits_ part-time (6-11 credits per semester fr undergraduate; 6-8 credits per semester fr graduate student)
4 Edward T. Cnry Memrial Schlarship Cntact Infrmatin SECTION C - Family Infrmatin: The fllwing infrmatin pertains t the family member wh was killed as a result f military service in the United States armed frces; r, as a result f service as a State r lcal public safety emplyee r vlunteer; r wh suffered a service cnnected 100% permanent disability as a result f military service; r, was a victim f the September 11, 2001 terrrist attacks. 1. Scial Security Number f persn killed r disabled: Last name f persn killed r disabled: First name: MI: 3. Relatinship f applicant t persn killed r disabled: 4. Branch f United States armed frces r name f public safety facility in which persn killed r disabled served, if applicable: 5. Date f death r disability: / / 6. Address at date f death/disability: City: State: Zip cde: 7. Are yu eligible fr the prgram because yu r yur parent was a POW/MIA f the Vietnam Cnflict? Yes N 8. Are yu currently receiving any ther student financial aid funds because yu are the child r spuse f a victim f the September 11, 2001 terrrist attack? Yes N If yes, please list schlarship name(s) and amunt(s): SECTION D (If applicable): In the case f 100 percent disabled r deceased military persnnel, and in the case f 25 percent (r mre) disabled military persnnel, please address the fllwing questins. Using a separate sheet f paper, explain the circumstances f the death r disability, the cause, and why it is cnsidered service cnnected. $ $ SECTION E - Pledge t Remain Drug Free and Certificatin: As a cnditin f receiving a Maryland State schlarship r grant, I pledge t remain drug free fr the full term f the award. Unlawful use f drugs and alchl may endanger my enrllment in a Maryland cllege as well as my Maryland financial aid award. I certify that the infrmatin given n this frm is true and cmplete t the best f my knwledge. Signature f applicant Date
5 Edward T. Cnry Memrial Schlarship Cntact Infrmatin Infrmatin Release Authrizatin: Disabled applicant/parent must sign the fllwing authrizatin statement: I, d hereby cnsent t the release f the requested infrmatin by the Veterans' Administratin r the State r Print full name f disabled persn lcal public safety persnnel ffice t the Office f Student Financial Assistance. Disabled persn's signature Date SECTION G - T be cmpleted by the Veterans' Administratin r the State r lcal public safety persnnel ffice. In the case f 100 percent disabled military persnnel: (name f disabled persn) Cde(s): has a 100 percent* disability rating, and his/her diagnstic cdes are: Percentage(s): *Veterans must be classified as 100% disabled (i.e., cannt be 90% disabled, but 100% unemplyable). In the case f 25 percent (r mre) disabled military persnnel: (name f disabled persn) Cde(s): has a 25 percent (r mre) disability rating, and his/her diagnstic cdes are: Percentage(s): This persn has exhausted his/her federal veterans educatinal benefits. This persn is n lnger eligible fr federal veterans educatinal benefits. In the case f deceased r 100 percent disabled public safety emplyees r vlunteers: Please briefly explain hw the death r disability f lcal public safety service: (name f deceased r disabled) was classified as a result f State r This ffice is unable t prvide the requested infrmatin. I hereby certify that the infrmatin prvided n this applicatin is crrect and cntained in ur recrds. Print name f authrized fficial Signature Title Address Phne number City State Zip cde Date
6 Edward T. Cnry Memrial Schlarship Cntact Infrmatin SECTION H - Required Dcumentatin N applicatin will be cnsidered withut the fllwing materials: Cmpleted Edward Cnry applicatin fr the academic year. Make sure yu have cmpleted all necessary sectins. Cpy f yur birth certificate shwing names f bth parents if yu are the sn r daughter f a deceased r 100 percent disabled military persn, POW/MIA f the Vietnam Cnflict, deceased r 100 percent disabled public safety emplyee r vlunteer, r deceased victim f the September 11, 2001 terrrist attacks. Cpies may be btained frm the State Department f Vital Recrds. Cpy f yur marriage certificate (if spuse f deceased public safety emplyee r vlunteer r f deceased victim f the September 11, 2001 terrrist attacks). Cpy f death certificate. Verificatin that yu are 25 percent disabled frm a service cnnected disability as a result f military service and have exhausted r are n lnger eligible fr federal veterans educatinal benefits. (Sectin G required.) Verificatin that death as a result f military service, r that death r 100 percent disability was in the line f duty fr a public safety emplyee r vlunteer. (Sectin C and Sectin G required.) Verificatin that 100 percent disability was frm a service cnnected disability as a result f military service. (Sectin C and Sectin G required. Nte: A cpy f the disabled veteran s award letter may be filed instead f Sectin G). NOTE: D nt send riginal certificate(s); they cannt be returned. Initial applicants are awarded based upn the pstmarked date a cmplete applicatin was received. NOTE: Awards are subject t the availability f funds. DEADLINE: Applicatin and all required dcumentatin must be received by July 15, Return applicatin by: MAIL FAX IN-PERSON Twsn University Financial Aid Office, Schlarship Unit 8000 Yrk Rad Twsn, MD Schlarship Unit Enrllment Services Center Rm 305 schlarship@twsn.edu Financial Aid Schlarship Unit Cntact Infrmatin: Phne: schlarship@twsn.edu Revised: 11/3/2017
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