Scholarship Application

Please complete the form below and attach a copy of a current transcript or report card and two letters of reference. Deadline for submission is February 28, 2018.

* indicates required field


About You

First Name*

Last Name*

Date of Birth*


School Enrolled*

School Street Address*

City, State, Zip*

Planned or current major*

Anticipated date of graduation*

If in college - are you enrolled full time or part time? (Must be enrolled in a minimum of 12 credit hours to be considered full time.)
Part TimeFull Time

How did you hear about the CNYSME Scholarship program?

Relationship to CNYSME member?

Applicant Home Address*

City, State, Zip*

Applicant Phone Number*


Two written references are required. One academic and one personal (non-family member)

Academic Reference (please list an advisor, counselor or teacher)


Street Address

City, State, Zip

Phone Number

Email Address

Relationship to Applicant

Personal Reference (please list a non-family member):


Street Address

City, State, Zip

Phone Number

Email Address

Relationship to Applicant

Activities & Community Involvement; please list memberships in clubs, sports, community groups, school activities, work experience, professional organizations or volunteer work

Current awards and honors received; please include both academic and non-academic

500-word essay describing your interests and career goals and how it relates to Sales and Marketing



Acceptable file types: doc,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 2mb.

Current transcript or report card

If you have letters of reference, please attach them here. If your references prefer, they can email to or mail PO Box 5334, Syracuse, NY 13220-5334

Academic letter of reference

Personal letter of reference