Team CPD Scholarship Application

Applicant Information

Applicant_____________________________________________________________
First Middle Last
Address_______________________________________________________________

City_____________________________________ State_______ Zip______________

Home Phone________________________ Cell Phone_________________________

Email_________________________________________________________________

School Information

High School Currently Attending ___________________________________________

Certification of GPA (2.5 Required)__________ Community Service Hours _________

List School Organizations

_________________________________ _____________________________

_________________________________ _____________________________
(School Administrator or Counselor Signature required)

School Administrator or Counselor _________________________________________

College or Trade School Attending__________________________________________________

Directions
Please submit with your application:
1. Letter of Recommendation from School Administer, School Counselor, or Community Leader.
2. Personal Statement/Scholarship Essay-(Maximum one page) The statement/essay should include:
personal history, academic and professional goals, how can a scholarship benefit you, why should
you be awarded a scholarship, detail community and/or volunteer services etc.)

Please return the application to:

Lt. David Payne
Charleston Police Department
Public Services Division Commander
501 Virginia Street
Charleston, WV 25301
Email: David.payne@charlestonwvpolice.org

DEADLINE FOR APPICATION June 1, 2022