Personal Information

First and Last Name *

Date of Birth *

Email *

Address *

City *

State *

Zip Code *

Phone Number *

Mid-Rivers Account Information

Mid-Rivers Account Number *

Member's Name *

Relation to Member *

Current School Information

High School Attended or Currently Attending *

College Attended or Currently Attending (If Applicable)

High School GPA *

College GPA (if applicable)

ACT/SAT Score *

Class Rank *

Class Total *

School/Community Activities and Awards

School Activities. Please provide years for each activity. *

Community and Volunteer Activities *

Awards and Honors Received *

Work Experience

The first employment section must be completed.

Employer *

Employment Type *

Position Title *

Employed From *

To *

Weekly Hours *

Job description *

Employer

Employment Type

Position Title

Employed From

To

Weekly Hours

Job description

Employer

Employment Type

Position Title

Employed From

To

Weekly Hours

Job description

Next Semester's School Information

What school will you be attending next semester? *

What type of school will you be attending? *

Field of Study *

School Admissions Office Address *

School Admissions Office Phone Number *

City *

State *

Zip Code *

Personal Biography

Briefly tell us a little about yourself. Be creative! We want to know more about you and your passions. *

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The Mid-Rivers Higher Education Scholarship Questions

Describe your long-term education and career goals. What steps have you taken so far to accomplish these goals? *

Describe an experience where you were unsuccessful in achieving your goal. What lessons did you learn from this experience? *

What would you describe to be your most unique or special skill that differentiates you from everyone else? *

Recognizing that technology changes at the speed of light, describe a technology that you think has had the most positive impact on our world today, and why. *

Do you see yourself returning to the area after graduation? What about living in this area appeals to you? *

Required Documents

Images must be .jpg, .png, or .jpeg only. Documents must be in .pdf, a Microsoft Word Document, .jpg, .png, or .jpeg only.

All files must be less than 5mb.

Profile Image *

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School Transcripts *

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Reference Letter *

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You must complete all required fields and save before you can submit your application.

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The Mid-Rivers Higher Education Scholarship

Personal Information

Mid-Rivers Account Information

Current School Information

School/Community Activities and Awards

Work Experience

Next Semester's School Information

Personal Biography

The Mid-Rivers Higher Education Scholarship Questions

Required Documents

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