THE 2016 IM FLASH
CTE SCHOLARSHIP PROGRAM APPLICATION
DUE DATE – January 15th, 2016
1. PERSONAL DATA
Name
Date
Permanent Address
Home Phone
City
State/Zip
Email Address
Cell Phone
Date of Birth
Name of College/University expected to attend
Expected College Major
2. EDUCATIONAL RECORD
Name of High School
Graduation Date
City
State
SAT/ACT Total
GPA on a 4.00 scale
1
3. ADVANCED COURSE WORK
List chronologically, beginning with freshman year, all Advanced Placement (AP), Honors,
Continuing Education (CE) and College courses taken. Attach additional pages if necessary.
Academic Year
Course
Credits
Grade or Test Score Received
If necessary use additional sheet in the back of the application:
4. ACTIVITIES AND SPECIAL RECOGNITION – School
List chronologically, beginning with freshman year, all activities in high school, such as
publications, club work, student government, athletics, honor societies, etc. Attach additional
pages if necessary.
Academic Year
Activity
Offices Held, Awards
If necessary use additional sheet in the back of the application:
5. ACTIVITIES AND SPECIAL RECOGNITION – Community
List chronologically, beginning with freshman year, activities outside of school in which you were
involved, such as clubs, groups, or teams (4H, Scouts, church, athletics, band, etc.), volunteer work
(Red Cross, camp counselor, etc.), etc. Attach additional pages if necessary.
Academic Year
Activity
Offices Held, Awards
If necessary use additional sheet in the back of the application:
2
6. EMPLOYMENT INFORMATION
Starting with freshman year, list all summer, part-time and/or full time jobs and provide dates of
employment, i.e. June 2014 – December 2015. Attach additional pages if necessary.
Dates of employment
Employer
Type of Work
If necessary use additional sheet in the back of the application:
7. ESSAY
Use separate sheets and attach to application. Answer the following questions in 250 words or
less for each answer.

Why did I choose my area of study (degree program) and how will using my degree
change the future?

State any special personal or family circumstances affecting your need for financial
assistance.
8. I (we) indemnify IM Flash Technologies and hold it harmless from any loss, damage, claim of
damage, or liability of expense arising out of, or resulting from, any aspect of this application or
this Scholarship Award Program. I (we) agree that I/we are aware of and understand all rules,
conditions, instructions and provisions regarding all aspects of this Scholarship Award Program.
Furthermore I (we) agree to accept the decision of the IM Flash Technologies Scholarship board
without debate.
I (we) agree that, in accepting this scholarship, I will attend an accredited college or university and
will maintain enrolled status for the academic year for which the award was given.
I (we) also agree that, if I withdraw or fail to meet attendance requirements for that academic
year, I (we) will reimburse IM Flash Technologies for the total scholarship amount.
I (we) certify that the information contained in this application is correct to the best of our
knowledge.
Applicants Signature______________________________________________________________
Date__________________________________________________________________
Parent/Guardian’s Signature______________________________________________________________
Date____________________________________________________________________
3
APPLICATION INFORMATION
Application submissions must include completed scholarship application, one short essay response,
official high school transcript and two letters of reference, including at least one from a teacher/advisor.
Student applicants are responsible for gathering and submitting all necessary information and awards
will be based on the information supplied. Therefore all application questions should be answered as
completely as possible.
Incomplete or late applications will not be considered. The Scholarship Committee reserves the right to
change or terminate the program at any time.
All submitted forms, transcripts, essay responses and information become the property of IM Flash
Technologies and will not be returned to the applicant. The intentional falsification or misrepresentation
of information will result in immediate disqualification and forfeiture of award.
APPLICATION CHECKLIST
Please use the following checklist to ensure that you have completed and submitted all of the necessary
information:
______ Application (3 pages & any additional attached pages if necessary)
______ Short Essay Response (single response)
______ Official High School Transcript
______ Two Letters of Reference (including at least one from a teacher/advisor)
APPLICATION SUBMISSION
Applications for the CTE Scholarship program are due January 15th 2016. Applications and supporting
documentation will be accepted by mail or hand delivery.
1. Mail: IM Flash Technologies, Attn: Todd Russell, 4000 N. Flash Drive, Lehi, UT 84043
(must be postmarked no later than January 15th 2016.
2. Hand deliver: IM Flash, Bldg. 10, RM 1150 (Main Lobby near Flag Poles)
3. Hand deliver: CTE Offices Alpine or Jordan School Districts. Date Stamped by January 15th 2016.
4
Additional: ADVANCED COURSE WORK
List chronologically, beginning with freshman year, all Advanced Placement (AP), Honors,
Continuing Education (CE) and College courses taken. Attach additional pages if necessary.
Academic Year
Course
Credits
5
Grade or Test Score Received
ACTIVITIES AND SPECIAL RECOGNITION – School
List chronologically, beginning with freshman year, all activities in high school, such as
publications, club work, student government, athletics, honor societies, etc. Attach additional
pages if necessary.
Academic Year
Activity
Offices Held, Awards
6
ACTIVITIES AND SPECIAL RECOGNITION – Community
List chronologically, beginning with freshman year, activities outside of school in which you were
involved, such as clubs, groups, or teams (4H, Scouts, church, athletics, band, etc.), volunteer work
(Red Cross, camp counselor, etc.), etc. Attach additional pages if necessary.
Academic Year
Activity
Offices Held, Awards
7
EMPLOYMENT INFORMATION
Starting with freshman year, list all summer, part-time and/or full time jobs and provide dates of
employment, i.e. June 2014 – December 2051. Attach additional pages if necessary.
Dates of employment
Employer
8
Type of Work