Edward T. Conroy & Jean B. Cryor Memorial Scholarship Program

0115 Mitchell Building

7999 Regents Drive

College Park, MD 20742

TEL: 301-314-TERP (8377)

www.financialaid.umd.ed

umdfinaid@umd.edu

OFFICE OF STUDENT FINANCIAL AID

Edward T. Conroy & Jean B. Cryor Memorial Scholarship Program

Purpose: The Edward T. Conroy and Jean B. Cryor Memorial Scholarship Program is designed to provide financial

assistance to sons and daughters of deceased, missing in action or prisoner of war United States armed forces

personnel, sons and daughters of deceased public safety personnel, surviving spouses (who have not remarried)

of deceased public safety personnel, disabled public safety personnel and sons, daughters and/or surviving

spouses of victims of the September 11, 2001, terrorist attacks, attending a Maryland postsecondary institution.

To be considered for the Edward T. Conroy Memorial Scholarship at the University of Maryland, College Park,

students must:

• The application must be received by July 15,2024

• Be a Maryland resident (with the exception of children of a State or local public safety

employee who died in the line of duty)

Applications may be submitted via email:

Email Address: umdfinaid@umd.edu

Renewal Students: Renewal awardees are not required to reapply each year. The Edward T. Conroy

Memorial Scholarship may be renewed on an annual basis for up to five years of full- time study or eight years

of part-time study (or a combination of both) provided their recipient:

• Is enrolled at least part-time

• Continues to meet all other eligibility requirements

0115 Mitchell Building

7999 Regents Drive

College Park, MD 20742

TEL: 301-314-TERP (8377)

www.financialaid.umd.ed

UMDFinaid@umd.edu

OFFICE OF STUDENT FINANCIAL AID

2024-2025 Edward T. Conroy & Jean B. Cryor Memorial Scholarship

Application SECTION A - Applicant Information: (Please Print)

1. UMD UID : - - Date of birth: / /

2. Last name: First name: MI:

Previous name under which records may be kept:

3. Permanent mailing address:

City: State: Zip code:

4. Home phone: Work phone:

5. E-mail address:

6. Are you a Maryland resident: Yes No

If you are a dependent student, are your parent(s) Maryland resident(s)? Yes No

7. Have you applied for this scholarship in the past? Yes No

8. Has someone else in your family received this scholarship Yes No

9. Name(s) of person(s) in your family who has/have received this scholarship:

10. Are you eligible for the program because you are a son, daughter, stepchild or surviving spouse of a victim of

September 11, 2001, terrorist attacks (deceased died as a result of the attacks on the World Trade Center, the

Pentagon or the crash of United Airlines Flight #93)? Yes No

SECTION B - Current College/University Information:

1. Complete name of the Maryland institution you will attend in 2024-2025 academic year:

2. Degree sought: Undergraduate Graduate Anticipated date of graduation: / /

3. In Fall semester 2024, I will enroll for: (please put a numeric amount in the space provided below)

# of credits full-time (12+ credits per semester for undergraduate; 9+credits per semester for a graduate student)

# of credits part-time (6-11 credits per semester for undergraduate; 6-8 credits per semester for a graduate student)

4. In Spring semester 2025, I will enroll for:

# of credits full-time (12+ credits per semester for undergraduate; 9+ credits per semester for graduate student)

# of credits part-time (6-11 credits per semester for undergraduate; 6-8 credits per semester for graduate student)

SECTION C - Family Information:

The following information pertains to the family member who was killed as a result of military service in the United

States armed forces; or, as a result of service as a State or local public safety employee or volunteer; or who suffered

a service-connected 100% permanent disability as a result of military service; or, was a victim of the September 11,

2001, terrorist attacks.

1. Last four (4) digits of Social Security Number of the person killed or disabled: _

2. Last name of the person killed or disabled: First name: MI:

3. Relationship of the applicant to the person killed or disabled:

4. Branch of United States armed forces or name of public safety facility in which person killed or disabled served, if

applicable:

5. Date of: death or disability: / /

6. Address at date of death/disability:

City: State: Zip code:

7. Are you eligible for the program because you or your parent was a POW/MIA of the Vietnam Conflict?

Yes No

8. Are you currently receiving any other student financial aid funds because you are the child or spouse of a victim

of the September 11, 2001, terrorist attack? Yes No If yes, please list scholarship name(s) and

amount(s):

SECTION D - Pledge to Remain Drug-Free and Certification:

As a condition of receiving a Maryland State scholarship or grant, I pledge to remain drug-free for the full term of

the award. Unlawful use of drugs and alcohol may endanger my enrollment in a Maryland college as well as my

Maryland financial aid award.

I certify that the information given on this form is accurate and complete to the best of my knowledge.

Signature of applicant Date

Section E- Information Release Authorization

Disabled applicant/parent must sign the following authorization statement:

I, , do hereby consent to the release of the requested information by

(Print full name of disabled person)

the Veterans' Administration or the State or local public safety personnel office to the Office of Student

Financial Assistance.

Disabled person's signature Date

AGENCY CERTIFICATION

SECTION F - To be completed by the Veterans' Administration or the State or local

public safety personnel office.

In the case of 100 percent disabled military personnel:

has a 100 percent* disability rating, and his/her diagnostic codes are:

(Name of disabled person)

Code(s): Percentage(s):

*Veterans must be classified as 100% disabled (i.e., cannot be 90% disabled, but 100% unemployable).

In the case of 25 percent (or more) disabled military personnel:

has a 25 percent (or more) disability rating,and his/her diagnostic codes are:

(Name of disabled person)

Code(s): Percentage(s):

This person has exhausted his/her federal veterans’ educational benefits.

This person is no longer eligible for federal veterans’ educational benefits.

In the case of deceased or 100 percent disabled public safety employees or volunteers:

Please briefly explain how the death or disability was classified as a

result of State or local public safety service: (Name of deceased or disabled)

This office is unable to provide the requested information.

I hereby certify that the information provided on this application is correct and contained in our records.

FOR OFFICE USE ONLY

Print name of authorized official

Signature

Title

E-mail

Address

Phone

City

State

Zip code Date

SECTION G - Required Documentation

No application will be considered without the following materials:

o Completed application for the 2024-25 academic year. Make sure you have completed all the necessary

sections.

o Copy of your birth certificate showing names of both parents if you are the son or daughter of a deceased

or 100 percent disabled military person, POW/MIA of the Vietnam Conflict, deceased public safety

employee or volunteer, or deceased victim of the September 11, 2001, terrorist attacks. Copies may be

obtained from the State Department of Vital Records.

o Copy of your marriage certificate (if spouse of deceased public safety employee or volunteer or of

a deceased victim of the September 11, 2001, terrorist attacks).

o Copy of death certificate.

o Verification that you are 25 percent disabled from a service-connected disability as a result of military

service and have exhausted or are no longer eligible for federal veterans' educational benefits. (Section F

required.)

o Verification that death as a result of military service, or that death or 100 percent disability was in the line

of duty for a public safety employee or volunteer. (Section C and Section F required.)

o Verification that 100 percent disability was from a service-connected disability as a result of military

service. (Section C and Section F required. Note: A copy of the disabled veteran's award letter may be

filed instead of Section F).

NOTE: Do not send the original certificate(s); they cannot be returned.

Initial applicants are awarded based upon the postmarked date a complete application was received.

NOTE: Awards are subject to the availability of funds.

Application must be received by July 15, 2024 at:

Office of Student Financial Aid

Attn: Conroy Scholarship Committee

Email: umdfinaid@umd.edu