2018 ASIS Foundation CPP Accelerator Scholarship
Complete this form and email to your chapter at asisswo@gmail.com by 1 December 2018.

Applicant   Information:

Name:	ASIS ID #:	

Address:	
City/State/Zip:	
Phone:	Email:	
Employer:	Job Title:	
# years as ASIS Member:	# years in Security Profession:	

I plan to apply for the CPP exam on or around this date: ____________________ (Note: Voucher must be used by 1 April 2019; you will have two years to take the exam after approval of your application.)

Council Information (Please indicate if you are a Council Member, e.g. Women in Security, Young Professional, etc.)
Council/Chapter Membership: 		
Officer Name:	Officer Title:	
Phone:	Email:	

Please tell us about yourself: (Limit your answer to 500 words or less.)
 
1.	Describe your professional accomplishments and explain why you are a strong candidate for this scholarship. 

 

I certify that all information is true and correct to the best of my knowledge. I agree that if I am selected I will proudly promote certification and the ASIS Foundation to other Chapter members and security professionals. 

Signature: _________________________________________________________ Date: ______________ 

Subject to the ASIS Foundation stated scholarship criteria, winning applicants will be selected on an objective and
non-discriminatory basis, without regard to race, age, gender, religion, political beliefs, employment status, or any other factors that constitute unfair or illegal discrimination.

Application materials should be emailed directly to your chapter at asisswo@gmail.com.

Note: If selected for a scholarship, U.S. recipients will be required to complete an IRS W-9 form. 

1625 Prince Street
     Alexandria, VA 22314-2882 USA
+1.703.519.6200
Fax: +1.703.519.6299
www.asisfoundation.org