Gary L. Buffington Memorial Scholarship Application Form

Each year the ISA Foundation will award up to seven (7) scholarships to member company employees for the purposes of continuing education and/or professional development. These educational programs may include enrollment in a university, community college, technical training or any industrial channel skill development program that helps advance the individual’s career in the Industrial Supply Channel.

Member Company Considerations

Must be a current ISA member company in good standing – dues are paid and current and will remain so through the duration of any scholarship support.
Although not mandatory, the ISA Foundation encourages the member company to match a portion of the scholarship awarded to demonstrate the connection between ISA and its member companies on the importance of continued education and development for its employees.

Application Process

Member company solicits internal applicants with a focus on developing their core team.

Applicants may include any employee from any department within the member company looking to improve their education to help advance their career ideally within the member company.

Member company authorized representative (Sponsor) and applicant complete the online form located below.

Once selected by the ISA Foundation Board of Directors, the Scholarship Sponsor and Applicant will be notified accordingly.

Applicant will provide ISA a 30 to 45 second video sharing their education ambition and thanks to their member company and the ISA Foundation.

Winners will be announced each year and will be posted on the ISA website.

Scholarships awards are issued for the actual cost of the education, not to exceed the Scholarship defined value. Payments will be mailed to the awardee or their selected educational institution.

Awardee agrees to provide a copy of the course completion to ISA within one year.

Member company and applicant agree to provide ISA a 30-45 second follow up video recognizing the joint success of the applicant and member company for presentation to the broader membership via press release and/or ISA website.

Applicant
The following section of the form is to be completed by the applicant.
Applicant Information
First Name*
Last Name*
Title*
Years in Industry*
Please enter a number greater than or equal to 0.
Years with Company*
Email*
Phone
Education Program Description
School, Course Name, Curriculum Description
Education Program Description*
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Project Cost $*
Scholarship*
Applicant Statement
Applicant statement on why the applicant is deserving of a scholarship and how it will help them develop their career and contribute in a greater way within the member company organization.
Applicant Statement*
Sponsor Information
First Name*
Last Name*
Sponsor Title*
Email*
Phone
Company Name*
Street Address*
Address Line 2
City*
State
Zip
Applicant Signature
I agree to participate in the ISA scholarship videos as defined and will provide proof of course completion within one year.
Name*
Signature*
Date
Sponsor
The following section of the form is to be completed by the applicant's sponsor.
Sponsor Statement
To be completed by Sponsor. Statement on why the applicant is deserving of a scholarship and how it will help them contribute in a greater way within the member company organization.
Sponsor statement*
Sponsor Signature
I acknowledge that I am authorized to be the applicant’s scholarship sponsor and approve our company and the applicant to participate in the ISA scholarship videos as defined.
Name*
Signature*
Date
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

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