Midland Power Cooperative

Powerline Scholarship Application

ELIGIBILITY GUIDELINES

  • Have applied and been accepted into the Northwest Iowa Community College (NCC) Powerline or program (or show proof they are on a waiting list)
  • Student must start school within 12 months of the application deadline.
  • New students must have a high school GPA of 2.75 on a 4.0 scale (or equivalent) OR current students must have an NCC GPA of 2.75 based on 12 or more credits.
  • Submit a letter of reference from a high school instructor, guidance counselor, current employer, or manager of a member electric cooperative, which should address the applicant’s potential for success in the program chosen at enrollment.
  • Preference will be given to residents of Hardin County, Iowa.

TYPE OR PRINT ALL INFORMATION EXCEPT SIGNATURES

Completeness and neatness ensure your application will be reviewed properly.

APPLICATION DATA

LAST NAME: / FIRST NAME: / MIDDLE INITIAL
PERMANENT ADDRESS: (street) / (apt #) / (city) / (state) / (zip)
PHONE NO.
( ) / E-MAIL ADDRESS
LAST 4 DIGITS OF SOCIAL SECURITY # / DATE OF BIRTH
MONTH______DAY ______YEAR ______

PARENT OR GUARDIAN INFORMATION

LAST NAME: / FIRST NAME / MIDDLE INITIAL
PERMANENT ADDRESS: (street) / (apt #) / (city) / (state) / (zip)
PHONE NO.
( ) / E-MAIL ADDRESS
RELATIIONSHIP TO APPLICANT / IS APPLICANT A DEPENDENT OF THE PARENT/GUARDIAN? YES NO

HIGH SCHOOL DATA

HIGH SCHOOL NAME FROM WHICH YOU GRADUATED OR WILL GRADUATE THIS SPRING:
HIGH SCHOOL ADDRESS (street) / (city) / (state) / (zip)
ACTIVITIES, ACHIEVEMENTS OR HONORS:
GPA: ______(Most current NCC or High School.An official NCC or high school transcript of grades must be sent with this application. A clear explanation of the high school’s grading scale must also be submitted.)

WORK EXPERIENCE

EMPLOYER / POSITION / FROM-MO/YR / TO-MO/YR

COMMUNITY SERVICE ACTIVITIES

List all community service activities you have participated in during the past four years (e.g. hospital volunteer, Special Olympics, food pantry).

SERVICE ACTIVITY/ORGANIZATION / POSITION HELD / ACTIVE DATES

QUESTIONS (You may attach additional sheets of paper if necessary)

Why are you interested in pursuing a career as an electric utility lineworker?

How does an electric cooperative differ from other forms of utility organizations?

CERTIFICATION

I acknowledge that the decisions of Midland Power Cooperative are final. I certify that I meet the basic eligibility requirements of the program and have applied and been accepted into the Powerline program or have included proof that I am on a waiting list at Northwest Iowa Community College. I agree to provide proof of information I have given on this form. Falsification of information may result in termination of any scholarship granted.

APPLICANTS SIGNATURE / DATE
PARENT/GUARDIAN SIGNATURE / DATE

Mail to: Northwest Iowa Community College, 603 West Park Street, Sheldon, IA 51201 %Foundation Office