2020 Leigh O. Cortez Educational Leader Scholarship

Personal Information
Name*
First Name Middle Last Name
Address
Street Address Address Line 2 City State ZIP Code
Phone
Cell Phone
Email
Current Teaching Information
Name of District Where Currently Teaching:
Name of School:
Current Grade Level:
Number of years teaching:
Past Teaching Experience
Work Experience:
Name of School/District Dates (from/to) Grade Levels Taught
Educational Experience
Educational Experience:
Name of College/University Years Attended Degree Earned
Honors & Activities
Honors and Award Achievements:

Please list any honors or awards you have received while teaching.
Community Service Activities
Name of Organization Dates (from/to) Average hours per month Activities / Positions

Please list any involvement with nonprofit, community, civic and/or faith-based organizations.
Graduate Work
Name of University Graduate Program Accepted Yes/No Intended start date

Please provide information on the graduate programs to which you have or are applying for this scholarship.
Personal Statement
In the space above, please describe your educational experience and how a graduate degree in education will help you with your career goals. (maximum 500 words)
Financial Need Statement
In the space above, please describe your financial situation and how this scholarship would benefit you. (maximum 350 words)
Applicant Signature
Date
Date Format: MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

Save and Continue Later

Name of Organization	Dates (from/to)	Average hours per month	Activities / Positions

Name of University	Graduate Program	Accepted Yes/No	Intended start date

Name of School/District	Dates (from/to)	Grade Levels Taught

Name of College/University	Years Attended	Degree Earned

Personal Information