David Parmentier Scholarship - Application

David Parmentier was a graduate of the class of 1979 at DePere High School. David is a former Captain at Green Bay Fire Department and has a great passion for the field. Working three jobs while in high school, he knew he wanted to continue his education and attended NWTC for one year in Police Science.

When he learned of a position for a Firefighter/EMT at the Allouez Fire Department, he applied and was accepted at the age of 19. Wanting to become a Paramedic, David applied and was accepted by the City of Green Bay in 1985. Achieving Paramedic in 1989, he was promoted through the ranks to Captain. In 2005, due to an injury in the line of duty, he made the decision to retire with 30 years of combined service.

David said he couldn’t think of a better calling for him. Growing up on the family farm south of De Pere he learned early that life is a group effort. Hearing sirens, the family would load up their station wagon and head out. With the kids safe in the car, his Mom and Dad would help when and where they could.

The David Parmentier Scholarship will be a presented to a student who is entering into the field of public safety, which includes law enforcement, fire safety and Emergency Medical Services.

Name

First Name

Last Name

Middle Initial

Phone

(###)

###

####

Email Address

General email address that will be used after High School

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

SCHOOL INFORMATION

Grade Point Average (GPA) - High School

Number of Students in Class

Rank in Class or Laude Points

List in chronological order all schools attended in the last four years, including any summer or special courses.

Include - Name of school / Location (city) / Dates of Attendance

List any academic distinction or honors you have earned and the grade levels in which you earned them (9, 10, 11, 12)

ACTIVITIES

Note those activities in which you have been actively engaged (organizations, sports, or clubs) and which you feel have been most meaningful to you (include years of participation, grade, levels, and any offices held)

WORK EXPERIENCE

List employment you have held in the past three or four years

Position / Employer / During the Summer or School Year / Dates / Number of Hours Per Week

HIGHER EDUCATION AND PUBLIC SERVICE

If applicable, the College or University you have been accepted to

What field of study?

Anticipated enrollment date

YYYY

Have you been awarded (or reasonably expect to receive) other grants or scholarships?

Yes

If yes, please list the name of the scholarship and the amount you will receive below

FAMILY INFORMATION

Parents: (Check if living)

Mother

Father

Stepmother

Stepfather

Legal guardian

Number of Children in Family

If you have siblings, number who will be in college

ESSAY

Write a statement of NO MORE THAN 500 WORDS discussing your goals, what you consider to be your strong points, and why this scholarship should be awarded to you.

REFERENCES

Letters of reference are not required. However, at least one reference and no more than two references of the applicant’s choice should be named. The selection committee reserves the right to contact these references. References cannot be family members or peers.

Include - Name / Phone #

DUE DATE

Please submit by March 27th unless stated differently guidance office

SIGNATURE

I certify that all the above information is true to the best of my knowledge.

Type name below

Today's Date

YYYY