Application for the FAER

Purvis Ponder Orientation & Mobility Memorial Honorarium

This award is in memory of Purvis Ponder as a tribute to his years of dedication, commitment, and leadership within the field of orientation and mobility for persons with disabilities.  The intent of this award it to keep the spirit of Purvis’ life work alive by assisting other to also follow in the course of study of orientation and mobility.

By accepting the Purvis Ponder O&M Memorial Honorarium, a recipient pledges to be employed, following graduation, in a program or agency serving people with visual impairments in the state of Florida. A student who has received funding will provide service in an education, rehabilitation or related Florida position for at least one year and will have applied for O&M endorsement and/or ACVREP certification, or the funding will be returned to FAER. Should repayment not be made, collection agency intervention will be applied, and potential employers notified.

Promissory Statement: By completing this application, I promise to abide by the above-stated rule, and will work in a Florida agency/program or return the funds within 6 months of graduation.

Legal Signature                                                                       Date

Formal Application

1.             Name of Applicant­­­­­­­­­­­­­­­_______________________________________________

2.             Current Mailing Address___________________________________________

     ____________________________________________

Telephone___________________ Fax______________ e-mail_____________

3.             Permanent Address (of Name and Address of someone who will always know where/how to reach you after graduation)

Relationship to You ___________________________________________________

Telephone   ___________________ Fax ______________ e-mail_______________

4.             Academic Program:

What college or university do you attend?­­­­­­­­­­­­­­­­__________________________________

Who is the person in charge of your program in orientation & mobility?____________

What is the title of that person?___________________________________________

What is the address of that person?_______________________________________

      ________________________________________________________________

      ________________________________________________________________

      ________________________________________________________________

Telephone______________________ Fax _______________e-mail _____________

Please have that person, or another faculty member who knows your work, send a letter of recommendation to the Chairperson of the Scholarship Committee at the address below.

5.             Your progress:

When do you plan to graduate?­­­­­­­­­­­­­­­____________________________________

What are your current credit hours, related to O&M?____________________

What is your current major? _______________________________________

What is your grade point average to date?____________________________

Please have a current transcript sent directly to the Scholarship Committee at the address below, to arrive 10-14 days after the application is to be received.

6.             Written Statement

Please provide a written statement, on the following page, that describes your career goals, your experience in the field of visual impairment, and your hopes for the coming years. Let the committee know of any special experiences or interests that pertain to the goals of FAER and the area of orientation and mobility.

7.             Please mail the application, and have the transcript and letters of recommendation mailed to:

Ms. Karen Kane, Chairperson

FAER Scholarship Committee

14449 Augusta Rd.

Orlando, FL 32792

I hereby attest to the fact that the above statements and responses are factual and true.

          Legal Signature                                                                   Date