Connecticut State Prison Employees Union

AFSCME Local 391

Today's Date *

Applicant Name *

SAT Score *

High School and Address *

Members Job Classification *

Phone *

Members Name (must be applicants legal guardian) *

Electronic Application for Annual Local 391 Scholarship

Major *

List of scholastic activities, honors, significant awards, extra curricular activities, special interests, groups/organizations involved in, community service, etc. *

Members Employee Number *

Applicant Email: *

Check here to receive email updates

Address *

Number of Credit Hours *

College/University Name and Address *

Members Facility *