ITS Florida Training and Certification Scholarship Application Deadline
April 27, 2024

The Erika Birosak Training and Certification Scholarship is available to public*** and private sector nominees in which their respective organizations are members of ITS Florida. The scholarship assists those seeking to advance their skill set through additional training and certification courses, to better serve their organizations and the ITS industry in Florida. This scholarship amount is up to $1,000 reimbursement for successfully completing approved coursework within one year.

***Please check your organization's policy regarding scholarship acceptance.

Student Information

First Name *

MI

Last Name *

Employer (Organization Name)

Mailing Address *

City *

State *

Postal Code *

Phone

Email Address *

Nominator:

Employer (Organization Name)

Email Address *

Phone

Business Relation: *

How long have you worked with this individual? *

If Scholarship is awarded, a W9 will need to be completed.

Technical Ability: (25 points**)

Please briefly describe the technical ability of this individual that demonstrates excellence in independent and group support on Intelligent Transportation System projects in Florida. *

Project Experience: (25 points**)

Please identify chronologically the Intelligent Transportation Systems projects (with a brief description) this individual has performed in the field directly or indirectly with you. (Project experience may include but not limited to fiber optic installation, field splicing, erecting structure Dynamic Message Signs, erecting video detection systems, Traffic Management Center). Please cite the most recent project first. *

Certification Class Requested: (25 points**)

Please describe how this class will impve or assist the nominees skill set. Please include details of the class, cost, and location of course. *

Any other relevant information you wish to supply.

** Point value shown is maximum points available for each category.

Nominator's Signature *

clear

Submittal Instructions:

Complete this form with all attachments submitted no later than 5:00 PM Eastern Time April 27, 2024.

If scholarship is awarded, a W9 will need to be completed.

If you have questions, please contact ITS Florida at ITSFlorida@ITSFlorida.org.

*Indicates Required areas

** Point value shown is the maximum points available per category