Please fill out form, sign, and send via mail or scan and email.
Please fill out form, sign, and send via mail or scan and email.
BILINGUAL SPANISH SPEECH SCHOLARSHIP APPLICATION
Student Name ___________________________________________________________________________ Telephone ___________________________
Email ___________________________________________
Preferred Mailing Address __________________________________________________________________ City, State, Zip Code ______________________________________________________________________ University __________________________________
University Phone ____________________________
University Address_________________________________________________________________________ Anticipated Degree ___________________________
Anticipated Date of Degree Completion __________
Please answer the following question in an essay of 2000-2500 words: What impact do you see that you can make as a bilingual speech-language pathologist working with children? How are you preparing yourself to have that impact? Please include your name and page number on each page.
Send this form, your essay, a current resume, and a copy of your most recent (unofficial) transcript to: Cumberland Therapy Services Attn: Miriam Shalman 3701 N. Ravenswood Ave Suite 248 Chicago, IL 60613 To submit electronically, please send all materials to: [email protected] Please provide the faculty recommendation form to the faculty member of your choice and request they send it directly to Miriam Shalman. A select group of finalists will be invited to interview by phone during the month of June. st
Completed applications must be received by May 1 . Recipients will be announced and individually contacted by th June 30 .
I certify that, to the best of my knowledge, the information in this application is accurate.
Signature__________________________________________________
Date ____________________
Please fill out form, sign, and send via mail or scan and email.
BILINGUAL SPANISH SPEECH SCHOLARSHIP FACULTY RECOMMENDATION FORM Cumberland Therapy Services is proud to announce the Bilingual-Spanish Speech-Language Scholarship. The $2,500 award is funded by Cumberland Therapy Services, a leading provider of quality Special Education services in school settings. The scholarship will be awarded to a student enrolled in an accredited master’s program for Speech-Language Pathology with an expressed desire to provide bilingual speech therapy services to children in a school setting. st
th
Completed applications and forms must be received by May 1 . Recipients will be announced June 30 . Student’s Name ___________________________________________________________________________ University Name and Department _____________________________________________________________ Your name ________________________________________ Phone number__________________
Title_________________________________
Email address ____________________________________________
Please answer the following questions by circling or underlining Yes or No. Is this student pursuing a master’s degree in your program? Yes No Will the student be enrolled full-time in the program for the 2014-2015 school year? Yes No To your knowledge, has the student expressed interest in pursuing a speech-language pathology career providing bilingual Spanish services in a school setting? Yes No Does the student currently have a level of fluency in Spanish sufficient to provide speech services to children who are native Spanish speakers? Yes No Do you think the student possesses the skills and desire to succeed in a school setting? Yes No Would you recommend this student for this scholarship? Yes No
Please briefly detail what leads you to recommend (or decline to recommend) the student for this scholarship. _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
Is there anything that stands out about this student that makes them a good candidate for this scholarship opportunity? Please describe. _________________________________________________________________________________________
Please fill out form, sign, and send via mail or scan and email.
_________________________________________________________________________________________ _________________________________________________________________________________________
I certify that, to the best of my knowledge, the information in this reference is accurate.
Signature__________________________________________________
Please send this completed form to: Cumberland Therapy Services Attn: Miriam Shalman 3701 N. Ravenswood Ave Suite 248 Chicago, IL 60613 To submit electronically please send to: [email protected]
Date ____________________
BILINGUAL SPANISH SPEECH SCHOLARSHIP APPLICATION
Student Name ___________________________________________________________________________ Telephone ___________________________
Email ___________________________________________
Preferred Mailing Address __________________________________________________________________ City, State, Zip Code ______________________________________________________________________ University __________________________________
University Phone ____________________________
University Address_________________________________________________________________________ Anticipated Degree ___________________________
Anticipated Date of Degree Completion __________
Please answer the following question in an essay of 2000-2500 words: What impact do you see that you can make as a bilingual speech-language pathologist working with children? How are you preparing yourself to have that impact? Please include your name and page number on each page.
Send this form, your essay, a current resume, and a copy of your most recent (unofficial) transcript to: Cumberland Therapy Services Attn: Miriam Shalman 3701 N. Ravenswood Ave Suite 248 Chicago, IL 60613 To submit electronically, please send all materials to: [email protected] Please provide the faculty recommendation form to the faculty member of your choice and request they send it directly to Miriam Shalman. A select group of finalists will be invited to interview by phone during the month of June. st
Completed applications must be received by May 1 . Recipients will be announced and individually contacted by th June 30 .
I certify that, to the best of my knowledge, the information in this application is accurate.
Signature__________________________________________________
Date ____________________
Please fill out form, sign, and send via mail or scan and email.
BILINGUAL SPANISH SPEECH SCHOLARSHIP FACULTY RECOMMENDATION FORM Cumberland Therapy Services is proud to announce the Bilingual-Spanish Speech-Language Scholarship. The $2,500 award is funded by Cumberland Therapy Services, a leading provider of quality Special Education services in school settings. The scholarship will be awarded to a student enrolled in an accredited master’s program for Speech-Language Pathology with an expressed desire to provide bilingual speech therapy services to children in a school setting. st
th
Completed applications and forms must be received by May 1 . Recipients will be announced June 30 . Student’s Name ___________________________________________________________________________ University Name and Department _____________________________________________________________ Your name ________________________________________ Phone number__________________
Title_________________________________
Email address ____________________________________________
Please answer the following questions by circling or underlining Yes or No. Is this student pursuing a master’s degree in your program? Yes No Will the student be enrolled full-time in the program for the 2014-2015 school year? Yes No To your knowledge, has the student expressed interest in pursuing a speech-language pathology career providing bilingual Spanish services in a school setting? Yes No Does the student currently have a level of fluency in Spanish sufficient to provide speech services to children who are native Spanish speakers? Yes No Do you think the student possesses the skills and desire to succeed in a school setting? Yes No Would you recommend this student for this scholarship? Yes No
Please briefly detail what leads you to recommend (or decline to recommend) the student for this scholarship. _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________ _________________________________________________________________________________________
Is there anything that stands out about this student that makes them a good candidate for this scholarship opportunity? Please describe. _________________________________________________________________________________________
Please fill out form, sign, and send via mail or scan and email.
_________________________________________________________________________________________ _________________________________________________________________________________________
I certify that, to the best of my knowledge, the information in this reference is accurate.
Signature__________________________________________________
Please send this completed form to: Cumberland Therapy Services Attn: Miriam Shalman 3701 N. Ravenswood Ave Suite 248 Chicago, IL 60613 To submit electronically please send to: [email protected]
Date ____________________
