PIA Scholarship Application

Please fill out the application below for the PIA Scholarship by March 15th. Applications will only be considered from students who are native to Wisconsin.

To prevent any loss of work, applicants are encouraged to prepare answers on a separate document and paste them into the application.

Any questions about the application or process should be directed to Shirley Faherty at sfaherty@piaw.org.

Fields marked with an * are required.

About You

First & Last Name *

Permanent Address Line 1 & 2 *

**Applications from students outside Wisconsin WILL NOT be considered**

City, State & Zip Code *

Phone *

Student Email Address *

Education

High School Graduated/Graduating From *

Current (or Future) College/University *

School Counselor Email *

Year in School/Education Level *

GPA *

**Transcripts must be provided if scholarship is granted. Minimum GPA of 2.5 or higher required**

Insurance-Related Field of Study *

Please list your current field of study. High School Students, please tell us your planned major/field.

Students must be pursuing an insurance-related field to be considered.

Business or Insurance-Related Coursework

Please list and courses you have or are taking that are related to insurance or business in general.

Work Experience & Extracurricular Activities

Please describe any work experience that you have outside of school:

Please list and describe any extracurricular activities that you are involved with:

Future Plans & Aspirations

Tell us about your Post-Graduation Career Plans:

Describe any unique qualities, achievements, or future aspirations that should inform our decision:

PIA Scholarship Application

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