Get Cal Trans Scholarship Application For The Transit And Paratransit Certificate Program Form

CAL-TRANS SCHOLARSHIP APPLICATION University of the Pacific Transit and Paratransit Certificate Program - Spring 2013 Scholarship Awards from 795. 00 - 1000. 00 Series Tuition 2295. 00 PERSONAL INFORMATION Confidential Date Name Title Organization Supervisor/Title Address City State Zip Telephone Fax E-mail Address Are you an transit employee or a contractor Course Location Northern Southern Number of employees reporting directly to you San Diego Funding Does your organization have funding for training programs Yes Can your organization provide 10 matching funds for training Yes No Does your organization receive Federal Transit Administration FTA funds Yes If yes which of the following FTA Section 5303 FTA Section 5310 Check all that apply to your organization For-Profit Not-For-Profit Non-Profit Govt Please indicte the types of transportation services your organization provides Fixed Route Demand/Response Both N/A Where does your organization provide services Rural Urban If both enter percentage of service in area Explain how your attendance will benefit your organization Please explain why your organization needs financial assistance fo this program DISCLOSURE If approved you agree to register for the full series pay 2295. 00 less your award in tuition. Acceptance of scholarship funding indicates a commitment for course completion on your part. CAL-TRANS SCHOLARSHIP APPLICATION University of the Pacific Transit and Paratransit Certificate Program - Spring 2013 Scholarship Awards from 795. 00 - 1000. 00 Series Tuition 2295. 00 PERSONAL INFORMATION Confidential Date Name Title Organization Supervisor/Title Address City State Zip Telephone Fax E-mail Address Are you an transit employee or a contractor Course Location Northern Southern Number of employees reporting directly to you San Diego Funding Does your organization have funding for training programs Yes Can your organization provide 10 matching funds for training Yes No Does your organization receive Federal Transit Administration FTA funds Yes If yes which of the following FTA Section 5303 FTA Section 5310 Check all that apply to your organization For-Profit Not-For-Profit Non-Profit Govt Please indicte the types of transportation services your organization provides Fixed Route Demand/Response Both N/A Where does your organization provide services Rural Urban If both enter percentage of service in area Explain how your attendance will benefit your organization Please explain why your organization needs financial assistance fo this program DISCLOSURE If approved you agree to register for the full series pay 2295. 00 less your award in tuition* Acceptance of scholarship funding indicates a commitment for course completion on your part. Your employer must commit to the nine days of class time necessary for you to complete the entire certifcate course. TO APPLY FAX your application form to 209. 946. 2586 E-MAIL westgate pacific*edu CALL 209. 946-2956 or 888. 439. 2867 MAIL your scholarship application to Westgate Center for Leadership Development Eberhardt School of Business University of the Pacific 3601 Pacific Avenue Stockton CA 95211.