Teamsters Local 767 Scholarship Application

TEAMSTER LOCAL 767
SCHOLARSHIP FUND, INC.
TYPE OR PRINT ALL INFORMATION EXCEPT
FOR SIGNATURES
If space provided in any section proves inadequate,
information may be continued on additional sheets of
paper and attached to the application.
Application postmark deadline Thursday, April 30, 2026 at
5:00 PM

Please attach your Tell Us About Yourself Essay at the bottom of the form. (Minimum of 500 words)
APPLICATION DATA
STUDENT NAME*

First NameMiddle InitialLast Name
Phone Number*
Please enter a valid phone number.
PERMANENT HOME MAILING ADDRESS*

Street Address

Apartment #

CityState / Province

Postal / Zip Code
DATE OF BIRTH*

MonthDayYear
PHONE*
SOCIAL SECURITY NUMBER*
APPLICATION PARENT OR GUARDIAN INFORMATION
PARENT NAME*

First NameMiddle InitialLast Name
EMPLOYER*
EMPLOYEE LOCATION*
STATE*
PARENT PLACE OF WORK:*

AERONAUTICALAMERICOLDDANONETRINITY METROMOLSON COORSBIMBOUPSSCHWERMANSAFRANREFRESCO
WORK PHONE*
RELATIONSHIP TO APPLICATION APPLICANT IS A DEPENDENT OF TEAMSTER 767*

YESNO
EMPLOYEE ID #*
LAST 4 # OF SSN*
HIGH SCHOOL DATA
SCHOOL NAME*
NAME*
MONTH OF HIGH SCHOOL GRADUATION*
YEAR OF HIGH SCHOOL GRADUATION *
PRINCIPAL*
TELEPHONE*
HIGH SCHOOL ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
SCHOOL DATA
Name of school(s) you plan to attend. (If unknown, please list in order of preference the schools to which applications for admission have been sent.) - Please include SCHOOL NAME, CITY, and STATE.*
What year university*

4yr. College or University2 yr. Community or Junior CollegeOther, explain
Major course of study*
Application date of graduation*

MonthDayYear
Date
Student*

live on campuslive off campuscommute from home
WORK EXPERIENCE
Describe your work experience over the past four years. Please include the dates of employment for each job, the approximate number of hours worked per week, and the amount earned.

Work Experience

	Company/Position	From Month / Year	To Month/Year	Hours per Week	Amount Earned
-

Work Experience - Second Workplace

	Company/Position	From Month / Year	To Month/Year	Hours per week	Amount Earned
-

Work Experience - Third Workplace

	Company/Position	From Month/Year	To Month/Year	Hours Per Week	Amount Earned
-

ACTIVITIES AWARDS AND HONORS
Please list all school and community activities you participated in during high school, including any clubs, sports, volunteering, awards, or leadership roles.

	Activity	No. of Years Partic,	Special Award Honors	Offices Held	Activity	No. of Years Partic.	Special Awards Honors	Office Held
1
2
3

GOALS AND ASPIRATIONS
Make a statement of your plans as they relate to your educational and career objective and future goals.*
Upload your "Tell Us About Yourself" Essay here or email essay at scholarships@local767.com

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APPLICATION DATA

APPLICATION PARENT OR GUARDIAN INFORMATION

HIGH SCHOOL DATA

SCHOOL DATA

WORK EXPERIENCE

ACTIVITIES AWARDS AND HONORS

GOALS AND ASPIRATIONS