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 completes the enclosed forms and submits to McKenzie Zutell at mzutell@isapartners.org

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

Member company and applicant agree to provide ISA a 30 to 45 second video (ie: iPhone video) sharing their education ambition and thanks to their member company and the ISA Foundation.

Winners will be announced at the annual ISA Conference typically April/May of each year through a video collage to all attendees and will be posted on the ISA website.

Scholarship Sponsor and Applicant submits completed results and reviews with a designated ISA Foundation Board Member.

Scholarships will be awarded upon the successful completion and the actual cost of the education, not to exceed the Scholarship defined value.

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*
Date Format: MM slash DD slash YYYY
End Date*
Date Format: 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.
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
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First-Time Attendee Non-Member Rate Policy

This policy is for first-time attendees whose company is not a current ISA member or, whose company has not been an ISA member for the past 3 years.

Defining “First Time”:

First-time denotes the company and not the individual person who is attending.

A company who has been an ISA member within the past three years would first need to renew their ISA dues before registering their employee(s) for the event.

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