Application Part I | The Educational Trust

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Scholarship Application Parts I & II 2018-2019

A scholarship program for assistance with tuition and books, managed by the Desk and Derrick Educational Trust, is offered to qualified student citizens of the United States or Canada who have completed two years of undergraduate studies with a minimum 3.2 overall grade point average on a 4.0 scale (United States) or 80% and above (Canada) and are enrolled in a full-time program (co-op programs do not qualify). Applicants must be pursuing a degree in a major field of study related to qualifying for full-time employment (in the petroleum, energy or allied industries) and have need of financial assistance. Please complete both pages of this application. Completed applications must be received at the office of the Desk and Derrick Educational Trust on or before April 1, 2018. This application is available at theeducationaltrust.org in PDF format. All information must be furnished; ILLEGIBLE OR HANDWRITTEN applications will NOT be considered (excluding Part III).

Step 1 of 2

Name *

First

Last

Date of Birth

Student ID Number

Phone

Sex

Female
Male

Citizenship

United States
Canada

Permanent Address

Address Line 1

Address Line 2

City

State

Zip Code

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

School Email *

Home Email *

Declared Major Field of Study

Degree Sought (B.S., B.A., M.S., Ph.D.)

College or University

Estimated Date of Graduation

High School

High School Location (City/State)

I hereby authorize and request the Student Financial Aid Office of

to release the following requested information to the Desk and Derrick Educational Trust.

Signature *

Clear Signature

Note: Transcript, Letters of Recommendation, and Part III will need to be mailed according to the PDF Instructions found on the Home Page.

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