WCI - CCC Sponsorship Application Form

Werner Construction Inc.

CCC Sponsorship Application Form
Course of Study:*
Degree:*
Section 1 - Personal Information
Name*
Telephone Number*
Email Address*
Social Security Number*
Address*
Parent’s Names and Telephone Numbers*
Are you related to any current or former Werner Construction (or affiliate) employee?*
If Yes, Whom?
Section 2 – Academic Information
Name of High School*
GPA:*
Did you graduate?*
High School Rank*
SAT/ACT Scores:*
Name of College (if applicable)
Last Year Completed*

1234
Section 3 –Activities and Interests
1. List and briefly describe your high school extracurricular activities (e.g. memberships in organizations, sports, etc.):
Organization Involved
Date of Involvement

MonthDayYear
Date
Position Held
Organization Involved
Date of Involvement

MonthDayYear
Date
Position Held
Organization Involved
Date of Involvement

MonthDayYear
Date
Position Held
Brief Description of your Responsibilities
1. List and briefly describe volunteer activities in which you have been involved:
Organization Involved
Date of Involvement

MonthDayYear
Date
Position Held
Organization Involved
Date of Involvement

MonthDayYear
Date
Position Held
Organization Involved
Date of Involvement

MonthDayYear
Date
Position Held
Brief description of how you participated:
1. List honors or academic awards you have received (e.g. scholarly activities, research, etc.):
Award/Honor
Institution/Organization
Date of Involvement

MonthDayYear
Date
Award/Honor
Institution/Organization
Date of Involvement

MonthDayYear
Date
Award/Honor
Institution/Organization
Date of Involvement

MonthDayYear
Date
1. List and briefly describe any work experience:
Position
Employer
Dates of Employment

MonthDayYear
Date
Position
Employer
Dates of Employment

MonthDayYear
Date
Position
Employer
Dates of Employment

MonthDayYear
Date
Brief description of your work responsibilities:
Section 4 – sponsorship interests
A. Why would you like to receive this sponsorship and begin a career with Werner Construction?*
B. What are your long term career goals?*
C. What makes you a great candidate for this sponsorship?*
D. 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. *
Section 5 – application submission
Please submit the following to be considered for the Werner Construction Sponsorship:
1. 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.
This application is due no later than ________________
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:

Werner Construction Inc.

CCC Sponsorship Application Form

Section 1 - Personal Information

Section 2 – Academic Information

Section 3 –Activities and Interests

Section 4 – sponsorship interests

Section 5 – application submission