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Click here for printable Scholarship Application.
 Criteria for Scholarship Consideration '10 Outstanding CSR of the Year - NOMINATION FORM
'10 Outstanding CSR of the Year - ENTRY FORM
  • Applicant has worked in the insurance industry for at least 2 years.
  • Applicant intends on completing and achieving the designation.
  • Applicant demonstrates a commitment to professional continuing education.
 20 Scholarships will be available for each Designation and are broken down as follows:
  • 10 Scholarships will be awarded to first time attendees.
  • 10 Scholarships will be awarded to individuals who are currently pursuing their designation.
 
Name
Agency/Company
Address
Phone
Email
 I am applying for a CISR Scholarship CIC Scholarship.
1. If you have taken part of the program already, please indicate what parts and the time frame in which you have taken it:
2. Please list individual and/or agency involvement in industry-related activities such as volunteering for association work, committees served on, activities, etc...
3. Please list previous insurance education courses attended and/or designations/certificates earned:
4. Are you a licensed producer? YES   NO
5. Please list your employment history in the insurance industry and time spent at each employer:
6. Please describe briefly why you want or need this scholarship:
All scholarship submissions must be received by April 1, 2010.

 If you have any questions, please contact Heather Kramer, CIC, VP of Training
at 800.222.2699 or email hkramer@massagent.com