2021 Lineman School Scholarship Application

2021 Lineman School Scholarship Application
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Date of birth

Month Day Year
E-mail
Phone Number

Area Code Phone Number
Have you applied to lineman school?

Yes No
If so, where?
Have you been accepted to lineman school?

Yes No
If so, where?
Start Date

Month Day Year
Are you related to any employee, retiree, foundation trustee or director of CEMC?

Yes No
If so, who and what is the relationship?
Have you been convicted of a felony?

Yes No
Name of high school
Graduation/GED Date

Month Day Year
Most recent work experience:
Current employer
Position
Date of employment

Month Day Year
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
References:

Please provide 3 character, personal or employment references of which we may contact.
Name

First Name Last Name
Phone Number

Area Code Phone Number
Name

First Name Last Name
Phone Number

Area Code Phone Number
Name

First Name Last Name
Phone Number

Area Code Phone Number
May we contact your references?

Yes No
Recommendation letters (one professional, one personal)
Professional Recommendation letter

Browse Files

Cancel of
Personal Recommendation letter

Browse Files

Cancel of
How did you hear about this scholarship?
Household or family income as listed on most recent year's tax return $
250-500 word essay explaining "Why I want to be a lineman"

Browse Files

Cancel of
I certify that all information reported on this application is true and correct to the best of my knowledge. I also agree to submit a certificate of completion at the end of the lineman training to Carroll EMC.

Yes
I grant permission to Carroll EMC to use my images or videos for communication and publicity purposes. I grant permission to Carroll EMC to text/or call me via the cell phone listed on this from.

Yes
Date

Month Day Year
Should be Empty: