Illinois Academy of Criminology Scholarship Application

Name of Applicant: _____________________________   Date of Birth  _____________

Address:  _______________________________________________________________

Phone # :  _________________________      E-Mail Address  _____________________

Current School, College, Major Area of Study and current Grade Point Average_______

            Indicate plans for furthering your education and why you feel you would be worthy of an IAC Scholarship (300 words or less):

            If awarded, I certify I will use this grant to further my education in a field consonant with the purposes outlined by the Illinois Academy of Criminology.

________________________, _______________________________________________

        Signature                           Print Name, Address & TX

                                                                     _____________________________________

                                                                     IAC Committee Member

Enclose copy of latest grade report

Mail to:  Illinois Academy of Criminology, PO Box 134, Lemont, Illinois   60439-0134