Gail Ryba Memorial Scholarship 2011 Application

Click here for a downloadable PDF. Sample below.

Applicant’s Contact Information

Applicant’s Name _________________________________________________________

Mailing Address_________________________________________Zip Code_________

Day Phone (      )_______-__________Evening Phone (       )______ - _____________

Email Address__________________________________________________________

Background Information

Traffic Skills 101 Instructor’s Name __________________________LCI#___________

TS 101/ Dated Completed___/___/___ Location _______________________________

TS 101 Written Exam Score________________Road Exam Score__________________

Are you fluent in Spanish? (circle one)  YES or NO

Are you fluent in any other languages other than English or Spanish? If so please list.

______________________________________________________________________

In 500 words or less please describe to the BCNM Bike Education Committee how you will meet the requirements of the Gail Ryba Memorial Scholarship within the two years the scholarship is awarded. (Please attach your response, type written, to the application page when submitting.)

Please email your application and your 500 word response to: This e-mail address is being protected from spambots. You need JavaScript enabled to view it by Jan. 10, 2011; or mail your application and typed 500 word response to BCNM Education Committee, PO Box 3326, Corrales, NM 87048, post marked by Jan. 10, 2011. Click here for the application process.

DEADLINE EXTENDED to March 1, 2011.

 

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