Scholarship Application

Please fill out and attach the Scholastic Record 2023 and the Financial Assistance Questionnaire (PDF).

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Name of Parent or Guardian(Required)

First Last

Parent or Guardian REMC Account Number(Required)

Name of High School(Required)

College or University You Plan to Attend(Required)

Address of College or University(Required)

Street Address Address Line 2 City State ZIP Code

School Type(Required)

College/University

Community College

Vo-Tech

Accredited?(Required)

Yes

Intended Major(Required)

Minor

Personal Achievements – School Activities

List the activities you participated in related to school, such as plays, student council, athletics, etc.

Click the + button to add a new row

Organization

Years

Office or Leadership Role

Personal Achievements – Non School Activities

List the name of the organization or activity in which you participated, years of participation and any leadership roles held

Click the + button to add a new row

Organization

Years

Office or Leadership Role

Work Experience

Describe your work experience over the last 4 years

Employer

Position

Length of Employment

Hours Per Week

Please list any unusual or personal circumstances you feel warrant attention

Please attach Scholastic Record (to be completed by high school principal or counselors)(Required)

Max. file size: 499 MB.

Please attach transcript of applicant's grades, signed by school official(Required)

Max. file size: 499 MB.

Please attach Financial Assistance Questionnaire(Required)

Max. file size: 499 MB.

Applicant Electronic Signature (Full Name)(Required)

Parent or Guardian Electronic Signature (Full Name)(Required)

Phone

This field is for validation purposes and should be left unchanged.

Scholarship Application

Personal Achievements – School Activities

Personal Achievements – Non School Activities

Work Experience

Main Office

Office Hours

Phone Numbers

Social Media

Rate Adjustment Starting April 1, 2023

Personal Achievements – School Activities

Personal Achievements – Non School Activities

Work Experience