Associate of Applied Science Degree

Process Technology

Associate of Applied Science Degree

SCHOLARSHIP APPLICATION

Amerchol • Grand Bayou • Louisiana Operations • St. Charles Operations • Sterlington • tions • Sterlington • Weeks Island

PTEC Scholarship Application

Deadlines

Mid-Career Adults 11/17/2014

High School Students 3/2/2015

Name:______

Last First Middle Initial

Mailing address:______

Address City State Zip Code

Birth Date (Mo/Day/Yr) ___/___/____ Gender: ____Male ____Female

Home Phone:______Cell Phone:______

E-Mail Address:______

Education

High School:______

City and State:______

Year of High School Graduation:______

High School GPA: (current)______

College:______

City and State:______

Did you graduate? ______Year graduated: ______Degree:______

Graduating Students

*ACT Scores: ____English ____Math ____Reading ____Science ____Composite Date:______

*SAT Scores: ____Verbal ____Math ____Written ____Total Date:______

*If available

Were PTEC courses offered at your high school? _____

If yes, what courses did you take?______

List courses taken in Math and Science:______

______

______

List any extracurricular activities and/or volunteer organizations you are engaged with:

______

Work History

Are you currently employed? ______

Company: Job Title: Phone:______

Address: From/To:______

Company: Job Title: Phone:______

Address: From/To:______

Aptitude

1.  Please answer the following questions to the best of your ability.

2.  How often do you wear your seat belt? ______

3.  Is there a time when wearing a seat belt is not necessary? _____ If yes, when? ______

4.  Approximately how much force is needed to lift the weight?

A 24lbs / B 10lbs / C 48lbs / D 12lbs / E 18lbs

5.  How much force is required to lift the weight?

A) 40lbs / B) 50lbs / C) 60lbs / D)70lbs

6.  If gear A is turning in the clockwise direction, in what direction will gear B be turning?

A)  Clockwise B) Counterclockwise

7.  Give an example of a time when you repaired a piece of equipment or machinery

______

Personal Statement

In 200 words or less explain how receiving a PTEC scholarship will impact your personal life and career goals.

______

High School Students- Please provide a current copy of transcript and one letter of recommendation from a non-family member.

Mid-Career Applicants- Please provide a copy of your college transcript if available.

OPTIONS TO RETURN APPLICATIONS

Mail – Dow Louisiana Operations

Attn: Dawn Saucier

P.O. Box 150-B 2306

Plaquemine, LA 70765

Scan & Email-

Drop-off- Dow Visitor Center before 3:00 p.m. on day of deadline

Application may be downloaded online at www.dow.com/louisiana/news/