I hereby formally request that I be considered for the Sylvia Jane Heck Scholarship award. I have read, understand, and agree to abide by the scholarship requirements and submit the following information freely and willingly to the Scholarship Committee to assist them in the selection of scholarship recipients. I have completed all the information on this application and certify that it is accurate and that my permission is given to verify and qualify all information provided in this application. Should I be chosen to receive this scholarship, I authorize the Texas Business and Professional Women's Foundation, Inc. to release my name and picture in marketing materials and/or the announcement of Scholarship awards. I understand that any award funds not used for this stated purpose must be refunded to TBPW Foundation.