Scholarship Application
Thank you for contacting the scholarship office. Please complete the application below, so we can assist you with your career goals.
First Name
Last Name
Email
Phone Number
Street Address
City, State and Zip code
The county in which you reside.
Date of Birth
Are you employed?
If you are not currently employed, are you receiving unemployment benefits? In case you were laid off, could you please provide the name of your previous employer and the date when you were let go?
100
If you are not employed at the moment and are not receiving unemployment insurance, how do you support yourself financially?
200
Are you a recipient of any state assistance? If so, could you specify the agency providing this assistance?
60
Are you a veteran?
Have you previously participated in training? If yes, could you specify the type of training you received and when it took place?
500
Which training program or course are you interested in? Could you also specify the name of the school you wish to attend?
200
In a paragraph below, please tell us about your career goals and how this training program will help you achieve those goals.
500
Funding for training is dependent on the individual completing the USWIB process, an individual’s eligibility, and the availability of funds. I have read and acknowledged the contents of this statement.
20
ACKNOWLEDGEMENT & SIGNATURE By signing this application, I certify that all of the information provided is true to the best of my knowledge.
*
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