Wayne Willink Cooperative Leadership Scholarship Application
Toapplyusingthis form:
1. Saveformonyourcomputer.4. Giveyourprincipal/guidance counselortheirformtocomplete.
Wayne Willink Cooperative
Leadership Scholarship
1925RidgewaySt.
Hammond,WI54015
(t) 715-796-7000 | 800-924-3407 (f)715-796-7070
(e)
2. Fillinthefields.5. Mailorscanemailallcompletedformsandpaperworktotheaddress above.
3. Savethecompletedformagain. 6. Youmayalsoprintthisformandfillitoutbyhand.
DEADLINE:March16,2018
Date:
Studentname:
Parent/Guardianname(s):
St.CroixElectricaccountnumber:
SCEC Service Address (include city, state, zip code):
Mailing Address (if different than above):
Emailaddress:
Homephone:
Highschoolcurrentlyattending:
Whatisyourplannedmajororgeneralareaofstudy?
Wheredoyouplantoreceiveyourpost-secondaryeducation?
Listyourhighschoolactivities. Indicateclassyear(s)youparticipatedandhonorsorofficesheld.
Grades participated
Activity / 9th / 10th / 11th / 12th / Honors or offices heldIndicate additionalactivitiesandresponsibilitiesoutsideofschool.
Family:
Employment:
Youth/Church organizations:
Other:
Listanyhobbies,specialinterests,etc.
Haveyoubeen involved in a cooperative-sponsoredevent, such as Co-ops Yes! Or Youth Leadership Congress? If so,pleaseshare yourexperienceandwhatyoulearned.
St.CroixElectricCooperativeisabusiness-muchlikeanyotherbusiness-but,inseveralways,itisunique.
Inabriefnarrative,explain whatbeingamemberofaconsumer-owned,not-for-profitcooperativemeanstoyou and whether/how cooperative membership influenced your future planned course of study.
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Explain your interest in agriculture and why you plan to pursue a career in agriculture.
How do you believe cooperatives can benefit the needs of farmers and the agricultural community?
Typed signature will be considered as valid as a handwritten signature.
Page 4 of 4Wayne Willink Cooperative Leadership Scholarship
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Wayne Willink Cooperative Leadership Scholarship
Wayne Willink Cooperative Leadership Scholarship
Guidance Counselor Form
Wayne Willink Cooperative
Leadership Scholarship
1925RidgewaySt.
Hammond,WI54015
(t) 715-796-7000 | 800-924-3407 (f)715-796-7070
(e)
Theapplicant'shighschoolprincipalorguidancecounselormustcompleteandsignthis form:
1. Fill out form entirely& sign.
2. Attach orinclude anofficialtranscriptwiththeform.
4. Eitherreturntheformandtranscripttothestudent, or mailtotheaddressabove.
5. Allinformationmustbepostmarked and/or at the office of St. Croix Electric Cooperative no later thanMarch 16,2018ortheapplicant willbeineligible.
6. Questions?ContactSt. Croix Electric Cooperativeat715-796-7000 or .
Studentname:
Studentaddress:
City:
State:
ZipCode:
School:
GraduationYear: 2018
Rankinclass:Numberingraduatingclass:
Testscores:
ACT:
Other:
Additionalinformationorcomments:
Principal/Guidance Counselorname(please print):
DEADLINE:March 16,2018
Principal/Guidance CounselorSignature
St. Croix Electric Cooperative is an equal opportunity provider.2018 St. Croix Electric Cooperative Continuing Education Scholarship