ELIGIBILITY:

Any high school senior who will be graduating at the end of the 2015 school year, whose parents or guardians are members of North Arkansas Electric Cooperative.

Must have a high school grade point average of 3.0 or higher on a 4.0 scale through the first semester of their senior year.
APPLICATION:

Student must complete and submit to North Arkansas Electric Cooperative by April 13, 2015 ; the
North Arkansas Electric Trust Scholarship Application, their high school transcript and three letters of recommendation. ALL APPLICATIONS MUST BE TYPED.
SELECTION:

Selection criteria will be based on scholastic achievement, school involvement, community involvement and financial need.
NOTIFICATION:

Scholarship student/recipient will receive notification directly from North Arkansas Electric
Cooperative.
DISBURSEMENT:

Each scholarship awarded shall be payable in two semesters as follows: o The first semester check in the amount of half of the scholarship will be paid to the college or vocational/technical school after the final drop date during that semester and after the student/recipient provides North Arkansas Electric Cooperative with registration documentation from the college or vocational/technical school. o The second semester check in the amount of half of the scholarship, will be paid to the college or vocational/technical school after the final drop date that semester and after the student/recipient provides North Arkansas Electric Cooperative with a copy of the 2 nd semester registration documentation and an official school transcript indicating that the student/recipient successfully completed the previous semester with a grade point average of at least 3.0 on a 4.0 scale. Appeals can be made if GPA is not met.
OTHER:

The scholarship must be used by student/recipient to attend, on a full-time basis, any accredited institute of higher learning.

Please call Leah Rouse at (870) 895-6239 with any questions.
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PERSONAL INFORMATION: ( Please type )
Applicant’s Full Name: ___________________________________________________________
Social Security Number: ______________________Date of Birth: ________________________
Applicant’s Email Address _______________________________________________________
Home Mailing Address: __________________________________________________________
Parent/Guardian’s Name: _________________________________________________________
Parent/Guardian’s North Arkansas Electric Account Number: ____________________________
Parent Home Phone: _________________________Parent Work Phone: ___________________
HIGH SCHOOL INFORMATION: (To be completed by counselor)
High School: ___________________________________________________________________
ACT Composite Score ___________
GPA__________________________
Class Rank/Size ________________
Transcript _____________________
Guidance Counselor’s Signature: ___________________________Phone: __________________
SCHOOL ACTIVITIES: ( List your high school activities in the order of interest to you)
______________________________________________________________________________
Activity
______________________________________________________________________________
Activity
______________________________________________________________________________
Activity
______________________________________________________________________________
Activity
______________________________________________________________________________
Activity
SCHOLASTIC ACHIEVEMENTS: ( List any special honors and awards you have won or earned)
______________________________________________________________________________
Name of honor or award Date Awarded
______________________________________________________________________________
Name of honor or award Date Awarded
______________________________________________________________________________
Name of honor or award Date Awarded
______________________________________________________________________________
Name of honor or award Date Awarded
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NORTH ARKANSAS ELECTRIC TRUST – 2015 SCHOLARSHIP APPLICATION
COMMUNITY ACTIVITIES: ( List your community activities in the order of interest to you)
______________________________________________________________________________
Activity
______________________________________________________________________________
Activity
______________________________________________________________________________
Activity
______________________________________________________________________________
Activity
______________________________________________________________________________
Activity
EMPLOYMENT :
(List any jobs you have held since entering High School)
______________________________________________________________________________
Employer Duties Dates of Employment Hours per week
______________________________________________________________________________
Employer Duties Dates of Employment Hours per week
______________________________________________________________________________
Employer Duties Dates of Employment Hours per week
COLLEGE, VOCATIONAL/TECHNICAL SCHOOL INFORMATION:
In which field do you plan to major? _____________________________________________________________
List the colleges or vocational/technical schools you are interested in attending in the order of your preference.
______________________________________________________________________________
School Date Applied Date Accepted
______________________________________________________________________________
School Date Applied Date Accepted
______________________________________________________________________________
School Date Applied Date Accepted
List any scholarships you have applied for or have received.
Scholarship
___________________________
___________________________
Amount
______________
______________
Received
_____________
_____________
Not Yet Awarded
______________
______________
___________________________ ______________ _____________ ______________
Where do you plan to live? (check one) In a college dormitory _____Off campus_____Home_____Other_____
What activities do you plan to participate in during college?
____________________________________________________________________________________________
____________________________________________________________________________________________
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NORTH ARKANSAS ELECTRIC TRUST – 2015 SCHOLARSHIP APPLICATION
FINANCIAL NEED INFORMATION: (This section must be completed by a parent or guardian of the applicant.)
List the ages of the dependent children in your family and the school or college they attend.
______________________________________________________________________________
Age School
______________________________________________________________________________
Age School
______________________________________________________________________________
Age School
List your employer and occupation:
______________________________________________________________________________
Parent/Guardian Name Employer Occupation
______________________________________________________________________________
Parent/Guardian Name Employer Occupation
Please circle the category that represents your annual household income:
Below $25,000
$25,000 - $50,000
$75,000 - $100,000
$100,000 - $125,000
$50,000 - $75,000 Over $125,000
List any savings you have for this applicant’s education. _____________________________________________
List any other information you would like to volunteer regarding your financial situation or family circumstances that would be helpful in the consideration for a scholarship.
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
_________________________________________________
Parent or guardian signature Date
Please attach the following required documents to complete your application:

A copy of your high school transcript.

Three letters of recommendation from a teacher, counselor, employer or community leader.
Please return application by April 13, 2015 to: North Arkansas Electric Trust
Scholarship Program
PO Box 1000
Salem, AR 72576
Attn: Leah Rouse
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