1. Personal
The Chris Thomas Memorial Fund
Providing assistance to aspiring Electricians
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Mobile Phone
*
Please enter a valid phone number.
Current School and/or Employment
*
Tell us why you'd like to be an electrician.
*
Did you graduate High School or Receive a GED?
*
Graduated High School
Received GED
Have not graduated High School
Graduating High School within the next 8 months
Receiving GED within the next 8 months
Proposed Field of Study
*
Schools you will be applying to:
*
3. Extracurricular Activities
School and Community Activities & Service: Please list below or attach a resume.
Description of Activity
Years Participated
Positions held/honors received
1
2
3
4
5
6
7
8
9
10
4. Work Experience
Please list any part time or summer jobs you have had.
Employer
Job Title
Hours per Week
Months Employeed
1
2
3
4
5
5. Financial Information
The following section is optional; however, if not completed, the information cannot help your consideration for our scholarship which does include financial need as a criterion. All information will remain confidential.
Are there any extenuating financial circumstances you would like to tell us about?
6. Upload Documents
Please upload the following required and optional documents:
School Transcripts
(Required)
Recommendation Letter from Teacher or Manager
(Required)
Resume
(Optional)
Document Upload
Browse Files
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of
Signature
Release Authorization and Certification of Accuracy and Terms Agreement
*
I HEREBY AUTHORIZE RELEASE OF ANY INFORMATION SHOWN ON THIS APPLICATION, TRANSCRIPTS, AND REFERENCES AS MAY BE REQUIRED BY THE SCHOLARSHIP COMMITTEE. I CERTIFY ALL INFORMATION PROVIDED HERE TO BE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. Scholarship winners must begin their studies in the term immediately following receipt of the award or in January of the following year. Each term’s earned grades must be sent to the Scholarship Administrator. Scholarships are not transferable and are forfeited if the student withdrawsor fails to meet the requirements for graduation from the school.If a serious life situation arises to prevent continuation of studies,the scholarship winner may request that the scholarship be held inabeyance for a maximum of 1 academic year.
Applicant Signature
*
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