Children of Members Scholarship Application

Are your parents/guardians residential members of Carroll Electric Cooperative, Inc.?

Yes

If yes, what's the account number?

Have you received a "full ride" scholarship to the school of your choice?

Yes

Are members of your family, or persons residing in your household, affiliated with ANY electric cooperatives/related entities?

Yes

If you answered No to question 1) and/or Yes to questions 2) or 3) – Thank you for your interest in our scholarship, but you do not qualify.

Application

Name

Phone

Street Address

City

State

Zip Code

Student Email

Parent Email

Parents' Names

Parents' Phones

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 including church and community

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

more items

School Activities Personal Achievement

Such as class officer, 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

more items

Personal Achievement

List all other activities heretofore not mentioned which will more fully describe your past achievements, including any work experience.

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

more items

Scholastic Record

Junior Year Class Rank

Senior Year Class Rank

Cumulative GPA (3.5 or above)

ACT Composite (if applicable)

SAT Composite (if applicable)

I authorize Carroll Electric to contact my school to request an official transcript

List Scholastic Awards Won (Local, county, district, or state)

Attachments

One teacher recommendation, no longer than 500 words

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

One recent photo of the applicant

One file only.
20 MB limit.
Allowed types: gif, jpg, jpeg, png.

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.

Applicant's Signature

Sign above

Parent/Guardian's Signature

Sign above

Date

Concern for Community:

Application

Non-School Personal Achievement

School Activities Personal Achievement

Personal Achievement

Scholastic Record

Attachments

Statement of Applicant, Parent or Guardian