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ACPD Gerry Bertier Scholarship Application
IMPORTANT - You must be a City of Alexandria resident or a student at a school located in the City of Alexandria to apply. All Gerry Bertier Scholarship applications must be received by April 30, 2026.
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Please use this as a checklist, checking each box to ensure the application is complete.
(Required.)
All areas of the application must be completed prior to submission.
Personal statement on how you plan to use your education must be explained clearly.
You must include the names of three references and their contact information.
Questions about the scholarship and completed applications should be directed to
ACPD@alexandriava.gov
APPLICANT INFORMATION
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Name of Applicant:
(Required.)
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Address (house number, street, city, state, zip):
(Required.)
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Email Address:
(Required.)
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Telephone Number:
(Required.)
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Date of Birth:
(Required.)
Date / Time
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Date of High School Graduation:
(Required.)
Date / Time
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Describe your disability:
(Required.)
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Identify specific school/program in which you intend to enroll:
(Required.)
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List and briefly describe awards and/or extracurricular activities:
(Required.)
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Other sources of financial aid for which you have applied or are receiving:
(Required.)
PERSONAL STATEMENT
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Please explain how you plan to use your education to help make the world a better place:
(Required.)
REFERENCES: Please provide three references. At least one is required. References may be from any of the following: teacher, counselor, mentor, or work supervisor.
Reference 1
Name of Ref. & Relationship
Telephone Number
Email Address
Reference 2
Name of Ref. & Relationship
Telephone Number
Email Address
Reference 3
Name of Ref. & Relationship
Telephone Number
Email Address
*
ACKNOWLEDGEMENT
(Required.)
To the best of my knowledge all of the information in the application is accurate and correct. I understand that selected for a scholarship. my name and photograph may be used for media coverage.
*
Name of Applicant:
(Required.)
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Date of Application:
(Required.)
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
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02
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Gerry Bertier Scholarship Award Guidelines
The applicant must be:
A person with a physical, sensory, or cognitive disability who is pursuing post-secondary education and
A resident of the City of Alexandria or a student at a school located in the City of Alexandria
The award will be:
Up to $1,000 per recipient per year
Available for tuition, room, board, supplies, or fees
Payable to the post-secondary institution
Usable over the length of the recipient's post-secondary educational career
Non-transferable
Forfeited to the extent that the funds are not used prior to completion or termination of the recipient's post-secondary educational career
The recipient shall:
Attend the ACPD Awards ceremony to receive the scholarship or shall be represented at the Awards Ceremony by an alternate
Provide feedback to the ACPD on the process for applying for the scholarship and the collection of the proceeds of the award.
Each application will be reviewed for the following criteria:Academic and extra curricular achievement.
Plans to give back to the community
References
Financial need
Previous Bertier Scholarship awards
For reasonable disability accommodation, contact
miladis.martinez@alexandriava.gov
or call 703.746.3140, Virginia Relay 711.
Send me a copy of my responses via email