Education Sponsorship Application

Education Sponsorship Application
Course of Study
Degree
Personal Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Social Security Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian's Name

First NameLast Name
Parent/Guardian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
2nd Parent/Guardian's Name

First NameLast Name
2nd Parent/Guardian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are you related to any current or former Werner Construction (or affiliate) employee?*
If so, who?
Academic Information
Name of High School
GPA
Did you graduate?
High School Rank
SAT/ACT scores
Name of College (if applicable)
Years completed
Activities and Interests
List and briefly describe your high school extracurricular activities (e.g. memberships in organizations, sports, etc.):
Extracurricular activity
Date of Involvement

MonthDayYear
Date
Position Held
Brief Description of your Responsibilities
Extracurricular activity
Date of Involvement

MonthDayYear
Date
Position Held
Brief Description of your Responsibilities
Extracurricular activity
Date of Involvement

MonthDayYear
Date
Position Held
Brief Description of your Responsibilities
List and briefly describe volunteer activities in which you have been involved:
Volunteer activity
Date of Involvement

MonthDayYear
Date
Position Held
Brief Description of your Responsibilities
Volunteer activity
Date of Involvement

MonthDayYear
Date
Position Held
Brief Description of your Responsibilities
Volunteer activity
Date of Involvement

MonthDayYear
Date
Position Held
Brief Description of your Responsibilities
List honors or academic awards you have received (e.g. scholarly activities, research, etc.):
List and briefly describe any work experience:
Position
Employer
Date of Employment

MonthDayYear
Date
Brief description of your work responsibilities
Position
Employer
Date of Employment

MonthDayYear
Date
Brief description of your work responsibilities
Position
Employer
Date of Employment

MonthDayYear
Date
Brief description of your work responsibilities
Sponsorship Interests
Why would you like to receive this sponsorship and begin a career with Werner Construction?
What are your long term career goals?
What makes you a great candidate for this sponsorship?
Is there any other information that we should know about you? This is your opportunity to include information that is not contained in other areas of the application. Please be specific.
Application Submission
Letters of Recommendations, Transcript, Copy of SAT/ACT scores

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Please submit the following to be considered for the Werner Construction Sponsorship:
1. This completed application form
2. Letters of recommendation from your high school faculty or counselor
3. For counselor use: Please submit a copy of the applicant’s transcript and a copy of ACT/SAT scores.
Please direct any questions to: Brad Beck 402-990-4983
- Werner Construction will only consider applicants who have visited the Hastings CCC campus and have a letter of acceptance from Central Community College.
- Sponsorship money will be paid to Central Community College and used specifically for tuition, tools and tool box and books.
- Applicants for this sponsorship program are considered without regard to race, color, gender, national origin, religion, disability or any other prohibited discrimination as provided under applicable state and/or federal law.
Thank you for your interest in the Werner Construction Diesel Technology Sponsorship Program. We wish you the best of luck, but if you are not chosen, please stay in touch with us as we always looking for GREAT employees. We offer an exciting workplace and competitive wages.

Werner Construction. Building Careers
Applicant Signature
Date

MonthDayYear
Date
I, the submitter, certify that the information given by me is correct. My submission of this form indicates that I have read and fully understand the above Applicant Statement.
Should be Empty:

Education Sponsorship Application

Personal Information

Academic Information

Activities and Interests

Sponsorship Interests

Application Submission