Form C1

Name*
First Last
Middle Initial
Email*
Applicant's School*
I am applying for the following scholarship(s)*
- Frank C. Heinisch Memorial Scholarship - $15,000
- OEA Foundation Presidents' Scholarship (12) - $10,000 each
- OEA Foundation Scholarships (10) - $7,000 each
- Thresa Clark Honorary Scholarships (7) - $6,000 each
- Jennie Kriebs Memorial Scholarship - $1,400
How are you related to the OEA or OEA-Retired Member?*
Name of OEA or OEA-Retired Member:*
Name of school where they are teaching or OPS schools where they taught (max of 3) and the number of years at each school. If they taught at more than 3 schools, list the three where they had the longest tenure and add “additional schools, ‘x’ number of years.”*
List the OEA or OEA-Retired activities/services in which the parent/grandparent has participated. This should include all OEA committees and offices held including AR, work done for endorsed candidates and service on joint OEA/OPS committees as a representative of the OEA. (100 words max):*
I certify that I have been an OEA or OEA-Retired member in good standing for the following number of years:*
Signed:*

Electronic signature of Parent or Grandparent
Thank You!
For current members, a minimum or three years OEA membership required for the above scholarships
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Thank You!