Welcome to the 2017-2018 HCM Roth IRA Award Application. Answering the below questions will assist your school in the selection process.

Name of School: *

Current Grade Level: *

Full Name *

Birth Date: *

Current Age *

Email Address: *

Home Address: *

Do you currently have a job? *

Yes

Name of Employer:

How long have you been working at your current employer? Reply in years. For example- 1.5, .5, .25, 2.5, etc

If not currently employed, have you had prior jobs? If so, please list them here. Just names of companies.

A few questions to answer.

Describe the jobs you’ve had?
Explain the lesson(s) you have learned that you believe will help you in the future as an employer or employee.

Describe the most impactful personal financial lesson that you have learned from your family or class.
Explain how you plan to implement that lesson in the future. *

Explain the significance of this award to you. *

Parents' or Guardian Contact Information

Name Parent or Guardian #1: *

Name Parent or Guardian #2:

Phone# Parent or Guardian #1: *

Phone# Parent or Guardian #2:

Email address Parent or Guardian #1: *

Email address Parent or Guardian #2:

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