Children of Members Scholarship | North Central Electric Cooperative

1. Are your parents/guardians permanent residential members of North Central Electric Cooperative?

Yes

2. Have you received a "Full Ride" scholarship to the school of your choice?

Yes

3. Are members of your family, or persons residing in your household, employed by, or a trustee of, ANY electric cooperatives/related entities?

Yes

If you answered NO to the first question, and/or answered YES to the second or third questions - Thank you for your interest in our scholarship, but you do not qualify.

Full Name

Phone Number

Street Address

Township

City

State

Zip Code

Student Email

Parent Email

Parents' Names

Parents' Phone Numbers

Age

Birthdate

Name of High School

Address of High School

By which college(s) or accredited technical school(s) have you been accepted?

Major(s)?

NON-SCHOOL PERSONAL ACHIEVEMENT

Activities include church, community, and work experience. Give years of membership and outstanding activities in which you have participated as a leader.

Re-order	Activity	# of Years	Remarks	Weight	Operations
	Activity	# of Years	Remarks	Item weight

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SCHOOL ACTIVITIES PERSONAL ACHIEVEMENT

Such as class officer, class ranking, plays, athletics, music, etc. List the most prestigious activities participated in during your high school attendance.

Re-order	Activity	# of Years	Remarks	Weight	Operations
	Activity	# of Years	Remarks	Item weight

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SCHOLASTIC AWARDS WON

List any scholastic awards received ((local, county, district, or state) during your high school career.

Re-order	Activity	# of Years	Remarks	Weight	Operations
	Activity	# of Years	Remarks	Item weight

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SCHOLASTIC RECORD

Official School Transcript (must be signed by a school official)

One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Since grade point scales vary by district, please provide a brief explanation of your school’s grade point scale (e.g.“out of a possible 4.0”) or include a copy and /or description of the scale with the transcript.

Cumulative Grade Point Average

(3.5 or above)

This GPA is based on a:

4.0 scale

5.0 scale

Blended grading scale

ACT Composite (if applicable)

SAT Composite (if applicable)

Attachments:

One teacher recommendation (no longer than 500 words)

One file only.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

One recent photo of the applicant

One file only.
100 MB limit.
Allowed types: gif, jpg, png, svg.

STATEMENT OF APPLICANT, PARENT OR GUARDIAN

We have examined this application and the records are true, complete and accurate. In addition, we acknowledge and agree that the Cooperative and Ohio’s Electric Cooperatives, Inc. may disclose any or all of the information contained in this application and the supporting documents to the judges of the scholarship competition and to any employees of the Cooperative or of Ohio’s Electric Cooperatives, Inc. Official School Transcript must be attached.

Date

Applicant's Signature

Sign above

Parent / Guardian's Signature

Sign above