UAW, LOCAL 974

                       HEATHER HENNINGER SCHOLARSHIP FUND

                                                              APPLICATION

                                                                   2008 - 2009

 

 

Name:  _________________________________________________________________

 

Address:  _______________________________________________________________

 

Zip ____________    Phone (_______)_____________________

 

 

                        Date of Birth ________________   Male _____  Female _____

 

 

College Name:  __________________________________________________________

 

Freshman ___  Sophomore ___  Junior ___ Senior ___ Other ______________________

 

                        Class Hours ___________

 

 

UAW Local 974 Family Member: _____________________________________________

 

Badge __________  Relationship to 974 Member________________________________

 

Address:  _______________________________________________________________

 

         Zip ___________  Phone (_______)______________________

 

 

Only one entry per student.

 

Please complete and return application to the Insurance & Benefits Office.  It must be received by 4:00 pm on Friday, August 29, 2008.

 

                                                                             

                                                                                    Return to:  Insurance & Benefits Office

                                                                                                       Local 974 UAW

                                                                                                       3025 Springfield Road

                                                                                                       East Peoria IL  61611

 

 

 

bs,opeiu#9/afl-cio/clc