Dominion Technology Fund Scholarship Application
Dominion is committed to establishing and reinforcing an inclusive, creative and productive environment in which each employee feels accepted and respected and believes it is possible to achieve his or her fullest potential. With that in mind, we are pleased to collaborate with Communities In Schools-Richmond (CIS Richmond) to offer the Dominion Technology Fund Scholarship.

Open to students enrolled full-time in a field of study mutually beneficial to Dominion and the individual, the $2,000 scholarship assists students in achieving their fullest potential. This scholarship opportunity is available to students who have successfully participated as a CIS student, including those who participated in the Carver Promise initiative or attended a Performance Learning Center (PLC).

Program Guidelines & Eligibility Requirements
To be eligible for consideration, the following criteria must be met:
• CIS applicants must currently have a cumulative 2.8 GPA or above on a 4.0 scale.
• Performance Learning Center applicants must currently have a PLC 2.0 GPA or above on a 4.0 scale.
• At the time of applying, applicants must be graduating high school seniors who either are currently working or graduated after working with a CIS site coordinator.
• Scholarship awards will be subject to receipt of the applicant’s final grades and proof of enrollment as a full-time student for the current academic year at a certified credential training program or an accredited two-year or four-year college or university.

CIS of Richmond will accept applications at www.cisofrichmond.org through May 31, 2020. A panel will review all applications.

Applicant’s Checklist
Your application for this scholarship becomes complete and valid only when we have received all of the following materials:
• Completed Dominion Technology Fund Scholarship Application
• High school transcript (official copy)
• Letter of Recommendation
• 200 word essay discussing the following prompts
        1. How has your background influenced your personal development and perceptions regarding technology? Please
        include how you would contribute to the workforce of the future by pursing a degree in one of the related technology
        fields.
        2. How will being a recipient of the Dominion Technology Fund Scholarship help you achieve your career goals?
        3. Discuss your involvement in and contributions to a community near your school, home, or elsewhere. Explain how
        your involvement made a difference to others. What did you accomplish?


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Name (Last, First, Middle) *
Telephone Number *
Address (Street, City, State, Zip) *
Email Address *
High School (Name and Address) *
Attendance Dates *
Graduation Date *
Cumulative GPA *
PLC GPA (if applicable)
Certified Job Skills Training Program or College or University You Plan to Attend (Name and Address) *
Expected Date of Enrollment *
Intended Major/Credential *
Please list any extracurricular activities (Itemize any leadership roles)
Please list your employment history:
Place of Employment
Date of Employment
Duties and Responsibilities
Place of Employment
Date of Employment
Duties and Responsibilities
Place of Employment
Date of Employment
Duties and Responsibilities
Essay: 200 word essay discussing the following prompts: 1. How has your background influenced your personal development and perceptions regarding technology? Please         include how you would contribute to the workforce of the future by pursing a degree in one of the related technology fields. 2. How will being a recipient of the Dominion Technology Fund Scholarship help you achieve your career goals?  3. Discuss your involvement in and contributions to a community near your school, home, or elsewhere. Explain how your involvement made a difference to others. What did you accomplish? *
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Applicant Signature (type first, middle, last name) *
Date Signed *
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