Online Scholarship/Grant Application California Peace Officers’ Memorial Foundation 2020/2021 Scholarship/Grant Application Dependents of California peace officers who have died in the line of duty are eligible to receive annual scholarships from the California Peace Officers’ Memorial Foundation. Name* First Last Birth Date Date Format: MM slash DD slash YYYY Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email Peace Officer InformationName of peace officer killed in the line-of-duty:* First Last Officer's employing agency:*Officer's End of Watch date:* Date Format: MM slash DD slash YYYY Your relationship to peace officer:*College or Business/Trade School InformationCollege or Business/Trade School of choice:*(Proof of Enrollment must be Faxed to 916-944-2171 for application to be considered)Intended Major:Intended Career:G.P.A. at last school attended:Have you previously applied for and/or received a scholarship from the California Peace Officers Memorial Foundation? If yes, please list dates and provide most recent transcripts:In the space below please state why you feel you are deserving of a financial award.*This section must be completed.All of the information provided in this application is true to the best of my knowledge and I have read and understand the award requirements:* Yes OPTIONAL: Upon receipt of CPOMF Scholarship Program funds, I give permission for CPOMF to use my photo in print material and on the CPOMF website relating to their Scholarship Program.YesNoUpload PhotoCAPTCHANameThis field is for validation purposes and should be left unchanged.