2023 SCHOLARSHIP APPLICATION

The deadline for this application to be received by MCT is March 31, 2023, 4 PM

Name of Applicant

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Email Address: *

Daytime Telephone Number:

Date of Birth *

Month/Day/Year

Gender:

Name of High School attending: *

A. List any academic honors, awards and membership activities while in high school: *

B. List your hobbies, outside interest, extracurricular activities and school related volunteer activities: *

C. List your non-school sponsored volunteer activities in the community: *

Please tell us what profession you are pursuing and whether you will be entering the workforce or attending college: *

Name of parent(s) or legal guardian(s):

Parent/Guardian - 1

First Name *

Last Name *

Parent/Guardian - 2

First Name

Last Name

Address of parent(s) or legal guardian(s): (ONLY list address if different than your own.)

Address Line 1

Address Line 2

City

Zip/Postal Code

Parent/Guardian Daytime Telephone Number

Please upload your Essay (250 - 500 words) answering the question below: *

Describe how and by whom you were introduced to STEM and/manufacturing education and how that education has shaped who you are today.

Once you SUBMIT your application, please check your email as you will receive a STATEMENT of ACCURACY

Please sign and email this document to admin@manufactureCT.org with Subject Line: 2023 SCHOLARSHIP APPLICATION. * Your Guidance Counselor will also need to sign this document.