Adult/Undergraduate Scholarship Application

Applicant Information

Scholarship Type:

Undergraduate College ScholarshipAdult College Scholarship

First Name

Last Name

Permanent Address

Street

City

State

Zip Code

Email Address

Phone Number

Employer

Name of parent or guardian with Adams Electric account

Adams Account Number

Primary residence of PA?

Education

High School Graduation Year/Year GED Earned

Degrees/Certifications earned since high school

What post-secondary school are you currently attending?

What degree/certification are you working toward (must be undergraduate study)?

What degree/certification are you working toward?

I attend classes...(check all that apply)

In-personOnlineFull-timePart-time

If the program is accredited, by what governing body?

When did you begin the program (month/year)?

When will you complete the program (month/year)?

I have completed ___ credits (Must have completed one semester).

My program requires ___credits for completion.

Estimated cost of entire program (tuition, books, etc.).

Essays

How will this degree or program benefit you and your community in the future?

How are you meeting your financial responsibilities for continued education? May include school-to-work programs or other scholarship support.

What do you do with your time outside of school (community involvement, family, work, etc.)?

Why should you be considered for an Adams Electric scholarship? Please share any examples or supporting information you would like the scholarship committee to consider when reviewing your application, such as other financial obligations, family members attending college, commitments, awards, experiences, etc. (100 - 250 words required)

I confirm that I am 13 years old or older.

Yes

In compliance with the Children’s Online Privacy Protection Act.

File Attachments

Transcript

Transcript/Acceptance Letter

Head and shoulder photo