NREMC Scholarship Form

NREMC Powering the Future Scholarship Application
Student information
Please complete the information below.
Student Name*

First NameLast Name
Birth date*

MonthDayYear
Date
Student Phone Number*

Area CodePhone Number
Student Email*
Name of high school from which you will graduate*
Name of accredited school you will be attending in the fall*
What will be your major course of study?
Current GPA (Must be 3.0 or higher to be considered)
High school rank/number in class
SAT/ACT Scores
List your work experience, school related and/or community activities/honors*
Please upload your current high school transcript. (If selected, you will be asked to provide an official transcript in a sealed envelope from your school)*

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Please upload your FIRST letter of recommendation from high school staff, coaches, civic/business leaders or clergy. (Letters from relatives are not accepted)

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Please upload your SECOND letter of recommendation from high school staff, coaches, civic/business leaders or clergy. (Letters from relatives are not accepted)

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Please upload a high-resolution headshot/photograph (school pictures are acceptable)*

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I hereby agree that the attached application submitted to Northeastern REMC, has been executed accurately and completely, to the best of my ability and knowledge.*

I agree
I am also aware that any funds received from this scholarship must be applied to tuition and fees at a two or four year, accredited institution.*

I agree
Parent information
The names of both parents will be included in the scholarship announcement. If only one parent should be included, add "NA" in the name fields. The address information will be used to verify NREMC membership.
Father's name*

First NameLast Name
Mother's name*

First NameLast Name
NREMC Account Number:
Address of parent who is a NREMC member:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent Phone Number*

Area CodePhone Number
Parent Email*
example@example.com
I have examined this application, including uploaded documents, and to the best of my knowledge and belief, it is true and complete.*

I agree
I understand that my NREMC account must be in good standing for at least 12 consecutive months of the application deadline for my child to be considered for this scholarship.*

I understand
I give NREMC permission to use my child's name and photo in digital/print media if awarded.*

I agree
Student signature*

Clear
Parent signature*

Clear
Should be Empty:

NREMC Powering the Future Scholarship Application