Eligibility Criteria
Applicant’s permanent residence as indicated on college records or the high school of record must be within the states of Kansas or Missouri. Must attend or plan to attend one of the following programs:
Name
*
First Name
Last Name
Cell Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Alternate Phone Number
Permanent Home Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
School Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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Academic Information
School/University/College
*
Current GPA?
*
Current Student Status (High School Senior, Undergraduate, Graduate, etc)
*
Field of Study and Career Goals
*
Anticipated Graduation Date?
*
Concrete Courses or Education
*
List any completed or in progress courses relating to the concrete industry (include dates taken).
Work and Field Experience
*
List any internships, job-shadowing, job training, concrete related employment, etc.
Organizations and Leadership
*
List any student/professional organizations, roles held, and other extracurricular activities.
Upload Transcript/GPA
*
Browse Files
Drag and drop files here
Choose a file
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of
Upload Essay (one page max). Topic: "Why Concrete is Important To Me"
*
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of
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Financial Data
Anticipated College Expenses
*
$XXX,XXX
Tuition (year)
Books
Room & Board
Other
Total School Expenses
You/Your Family Total Contribution
*
$XXX,XXX
Tuition (year)
Books
Room & Board
Other
Total Family Contribution
Anticipated Financial Aid 2026-2027 School Year
*
$XXX,XXX
Scholarships
Grants
Loans
Work Study
Other
Total Financial Aid
Summary Financials for 2026-2027 School Year
*
$XXX,XXX
Total College Expenses
Total Family Contribution
Total Financial Aid
Total Funds Needed
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Conclusion
My personal information and statements:
*
I certify that the information contained in this application is true and that I have answered all questions to the best of my ability.
Thank you for participating. Please feel free to contact Kristen at CPG with any questions.
15700 College Blvd., Suite 103, Lenexa, KS 66219 www.concretepromotion.com Kristen@concretepromotion.com, 913-341-5800
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