Education Scholarship Application Form

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Date of Birth*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Scholarship Eligibility (check the requirement(s) you meet for this scholarship)*

Immediate family member (child, step child, foster child, underemployed/unemployed spouses) of individuals who are members of Dubuque Area Labor-Management Council member unions or who work for employers belonging to the Dubuque Area Labor- Management Council (see back page for list of organizations)Current employee/member of DALMC member organization seeking to upgrade their skills (see back page for list of organizations)Immediate family member or individual employed at Scholarship Program sponsor (sponsors listed on back of application)Youth and adults eligible for assistance under the Workforce Investment ActIndividual in the military that have been honorably discharged or their immediate family membersMember of the Tech WORKS programCompleted an Opportunity Dubuque program and wish to further their education

Name(s) of parents/guardians/spouse and their company and/or union (if eligible for scholarship through parents/guardians/spouse’s organization)

Name of employer if qualifying through employer

Career you are preparing for*

Name of school/program you are/will be attending*

When do you expect to complete or graduate from this program?*

Date

Why are you interested in this occupation? What are your hopes and aspirations?*

What information have you gathered to show that there is a need for qualified workers in this occupation or field in the Tri-State area? Show how many openings there are or how many are expected. What level of starting (entry level) compensation is being offered to persons entering this field? Include both salary/wages and fringe benefits.*

What are you already doing to prepare for success in this occupation (for example, jobs, activities, classes)?*

How many absences are acceptable during school and/or work? Why?*

What is your record of participation in volunteer school and/or community service and/or activities, if any?*

In addition to answering these questions, please gather and attach the following supporting materials:

A letter from an official at the school you most recently attended or your most recent employer, documenting your conduct and attendance records. Do not attach a school transcript. (See Guideline 7-A.)
One letter of recommendation from persons familiar with your potential for success in your chosen occupation (individuals with first-hand experience of your classroom or job performance). In addition to any other supporting information, this letter must address your reliability and work habits. Do not send more than two letters of recommendation. Do not submit letters from individuals who are relatives.

Upload your Conduct & Attendance Record Here

Upload your Letter(s) of Recommendation Here

If you are unable to upload these items, please mail them to:

Dubuque Area Labor-Management Council, P.O. Box 14, Dubuque, IA 52004-0014

All materials must be packaged together. Do not have letters mailed separately.

Education Scholarship Application Form

Educational Information

In addition to answering these questions, please gather and attach the following supporting materials:

If you are unable to upload these items, please mail them to: