The Pipe Liners Club of Tulsa - 2021 Scholarship
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The Pipe Liners Club of Tulsa – 2021 Scholarship
The Pipe Liners Club of Tulsa is an organization that promotes the advancement of pipeline engineering,
maintenance, and operation practices for the mutual benefit of the members and the industry.
The Pipe Liners Club of Tulsa, by means of a scholarship committee and board of directors, awards
annual scholarships to selected collegiate students. The scholarships awarded are comprised of a portion
of the assessed dues to the club, donations, and funds raised during the fiscal year. The Board of
Directors will determine the amount and number of scholarships granted each fiscal year, while
maintaining a fund corpus minimum of $4,000.00. The Scholarship Committee is composed of a
minimum of three (3) members appointed by the President.
The Scholarship Committee will review all applications and make awards, based on merit and the
student’s finances, to those students whose academic and extra-curricular activities show promise, a
desire to succeed, a commitment to make a positive contribution to others, and whose application
substantiates minimum requirements below.
Eligibility
Students must meet the following qualifications, complete the attached application, and submit it
postmarked by March 1st, 2021 to be eligible. ONLY MAILED APPLICATIONS ARE ACCEPTED.
Submit applications to: Pipe Liners Club of Tulsa, 321 South Boston, Suite 300, Tulsa, OK 74103
Qualifications
Candidate must be enrolled in an accredited School, College or University
Candidate must be classified as a sophomore, or greater for the fall semester of 2021. A
maximum of 4 scholarships can be awarded to an individual for undergraduate studies and 2
scholarships for graduate studies
Candidate must have completed an average of twelve (12) or more credit hours for
undergraduate studies and nine (9) or more credit hours for graduate studies per semester over
the previous 2 semesters (winter/summers excluded) with a C (2.0) or better grade point average
to qualify for a full scholarship. Part-time students will be considered, and partial scholarships
may be awarded on a prorated basis.
Candidate must be a child, grandchild, niece or nephew (steps and in-laws included) of a current
member of the Pipe Liners Club of Tulsa
Candidate’s relative (sponsor) must have attended six (6) approved activities/meetings during the
fiscal year of the award (August 1st – July 31st) with at least one approved activity being a
monthly meeting. The following events are available; the monthly meetings in September,
October, November, January, February, March, and April, the Annual Christmas Banquet, Fall
and Spring Golf Tournaments, Fall and Spring Clay Shoot, Fishing Tournament, Family Hockey
and Baseball events, and Pipeline College Classes. The sponsor must attend six of these. Also,
the sponsor shall have paid dues for the 2019-2020 fiscal year and the 2020-2021 fiscal year.
Candidate must complete application form and have official, certified transcript provided to the
committee.
Candidate cannot be a relative of current scholarship committee member
BE SURE TO SUBMIT A COMLETE APPLICATION. INCOMPLETE APPLICATIONS
WILL NOT BE CONSIDERED. ONLY MAILED APPLICATIONS ARE ACCEPTED.
1 of 5Pipe Liners Club of Tulsa
Scholarship Application
Application Deadline: March 1, 2021
Information must be filled out by applicant. Read all instructions carefully before completing. Please type or
print clearly. All areas must be completed for application to be reviewed.
Applicant Information Sponsor Information
Name (Last, First, Middle) Name (Last, First, Middle)
Address for Award Check Email Address
City State Zip Relationship to Sponsor
Telephone Number E-mail Address
Date of Birth
Male Female
College Plan
I am currently enrolled as a: Hours Presently Carried per semester:
1st year undergrad
nd
2 year undergrad
Intended Major:
3rd year undergrad
4th year undergrad
1st year grad school
2nd year grad school
Educational Background
Dates Degree/Diploma Grade
School Location
School Name Attended Date Point
(City/State)
(Month/Year) (Month/Year) Average
2 of 5Extracurricular Activities
Please list your current and past extracurricular school activities (clubs, sports, church, community service or
volunteer work) in which you have participated and specify whether high school or collegiate level. Note if you
are/were an officer.
Scholarships, Awards and Honors
Please provide information on any scholarships, awards or honors you have received and specify whether
received during high school or college.
3 of 5Employment Background (Attach additional pages if necessary)
On average, how many hours per week do you work during the school term? ________________
On average, how many hours per week do you work during the summer months? ______________
Location Dates
Employer Name Type of Work
(City/State) (Month/Year)
Military Service
Dates Type of
Service Branch Rank Duration
(Month/Year) Discharge
Note below School funds with approximate percentages
Source Percentage Comments
Earned Income
Scholarship/Grants
Loans Taken in Applicants Name
Parents/Family Support
Other (please provide detail)
Letters of Reference
Please include three sealed letters of reference. Two (2) from teachers or other adults who are familiar with your
achievements and abilities and one (1) from your sponsor. Instruct your reference to sign his/her name across
the seal of the envelope. Do not include relatives other than sponsor letter. Letters should be 200 words or
less. Unsigned/Sealed letters will not be reviewed.
Reference Name Address Phone Occupation
4 of 5Certification
I, the undersigned, certify that all of the information I have included in and with my application is true. I
understand that if I am selected for an award, I may be required to submit further proof of my relationship to a
Pipe Liners member. I agree that if I am selected for an award, I will do my best to be present for the awards
ceremony held at Stoney Creek Conference Center in Broken Arrow, OK on May 17th, 2021, and my name and
photograph may be used for publicity purposes with no additional compensation by the sponsors of this
scholarship program.
Signature Date
Application Instructions
1. Application must be filled out by the applicant. Please type or print clearly.
2. All requirements must be met and all information must be completed in order for the application to be considered.
3. Enclose with your application three sealed letters of reference. Two (2) from a teacher or other adult who is
familiar with your achievements and abilities and one (1) from your sponsor. Instruct your reference to sign his/her
name across the seal of the envelope (see example below). Applications without sealed letters of reference
will not be considered; do not send letters of reference separately.
4. Enclose an official, certified college or university transcript. Applications without official, certified
transcripts will not be considered. Official, certified electronic transcripts (not copies) provided by the
university are acceptable and can be emailed to scholarship@tulsapipeliners.org.
5. Retain a copy of the completed application for your files.
6. Applications must be signed in order to be considered.
7. All application documents must be postmarked by the application deadline to be considered.
ONLY MAILED APPLICATIONS ARE ACCEPTED.
Applications must be postmarked by March 1, 2021
Mail to: Pipe Liners Club of Tulsa
Scholarship Program
321 South Boston, Suite 300
Tulsa, Oklahoma 74103
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