Form C2

Form C2 should be completed if you are applying for the following scholarships: Bertha Neale Memorial Scholarship - $1,000 Frank Williams Memorial Scholarship - $750 Evelyn Brown Scholarship - $1,250 Jim and Elma Simpson Memorial Scholarship - $750 The applicant must pursue a post-secondary education, must be a son/daughter/grandchild of a member of the Omaha Education Association, Omaha Education Association-Retired or the NSEA affiliated Omaha Administrators Association members who are former OEA memver, and must be planning on a teaching career.
Last Name:*
First Name:*
Middle Initial:
Email Address:*
I am applying for the following scholarship(s):* Check all that apply.	Bertha Neale Memorial Scholarship - $1,000 Frank Williams Memorial Scholarship - $750 Evelyn Brown Scholarship - $1,250 Jim and Elma Simpson Memorial Scholarship - $750
Relation who teaches or taught:*	Mother Father Grandparent
Name of school where they teach (taught):
Number of years they have been an OEA member:
Please list OEA activities or services that she/he has participated in:
Please list why you have decided to enter the teaching profession:*
Please list your particular teaching interest (special area, level, or subject):*
For current members, a minimum of three years OEA membership is required for the above scholarships. By entering the confirmation code and submitting this form I certify that my parent or grandparent has been an OEA member for a minimum of three years.
Confirmation Code: Enter the code shown in the box before clicking on submit.
	Note: Fields marked by an asterisk (*) are required.