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CTDA Scholarships

Please note: If you encounter any issues with completing the below application, please contact connerlycommunications@gmail.com.

CTDA Scholarship Application

CTDA Scholarship Grant Fund Application

This is an application for a Scholarship Grant Fund from the CTDA (c)(3). It is available to owners, employees and/or dependents of California Tire Dealers Association member firms.

Once your completed application is submitted, the CTDA 501 (c)(3) Scholarship Committee will review it. The Committee will then contact qualified applicants for additional information. Letters will be mailed to those not qualifying at this time. Only one Scholarship Grant Fund will be awarded to any one applicant per school term.

All of the requested information is important. By submitting this application you are declaring that the information on provided is given by you voluntarily.

First and Last Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Birthday

Phone Number

Email Address

High School

Graduation Year

High School Address

Address Line 1

Address Line 2

City

State

Zip Code

High School Phone Number

Best Time to Call

Choice of Class Subject or Name of Trade School

Member Firm Name

Main Contact

Main Contact Phone

Employer Name

Employer Phone Number

Time with Employer

Hours Per Week

Amount of Scholarship Funds Requested (Max $2,000)

Comments

Signature

Clear Signature

Type First and Last Name

Today’s Date

Date

Time

If your application qualifies, you will be contacted by the 500 (c)93) scholarship grant fund committee with a request for additional information necessary to make a final decision on awarding a scholarship grant fund.

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