For High School Students

February 19, 2008

·              Any graduating senior residing in Mountain Electric Cooperative’s service area and who intends to enter a two-year or four-year accredited college on a full-time basis in the fall of the 2008 may apply.                                                      

·              Application must be made on the official Operation Pocket Change (“OPC”) Scholarship Application form.  THE FORM MUST BE COMPLETED and must include; two letters of recommendations, a certified transcript of high school grades, ACT or SAT scores (if required), class ranking, a copy of your FAFSA Student Aid Report, a copy of parents or guardian’s tax return and a close-up picture of applicant. Note that picture should be 2-1/2" x 3-1/2" in size, and should be close-up of applicant which would be suitable for newspaper publication, placed in a marked envelope and attached to application.(please do not use staple or paper clip)  Applications to a community college or technical school do not require ACT/SAT scores. The application must be turned in to Mountain Electric or the local HS guidance counselor no later than April 22. Applications submitted to Mountain shall be delivered to:

Att: OPC Scholarship Committee

Mountain Electric Cooperative

604 S Church Street

P.O. Box 182

Mountain City, TN 37683

·              Financial need, scholarship (GPA, ACT, SAT), accomplishments, other scholarships received, and faculty/employer recommendations will be considered in the selection of the recipient.

·              This year, there will be sixteen to twenty (16-20) scholarships available, each in the amount of $2,000.                    

·              The scholarship is available only through the end of this year.  The OPC treasurer will make payment directly to the college.  The student must present the OPC treasurer with a receipt verifying enrollment, class schedule and appropriate college contact information (including college billing department phone number/address and payment instructions).

·               The deadline for submitting documentation is January 1, 2009. Documentation received after the deadline will not be accepted and scholarship recipient will forfeit all rights to the award. If the scholarship recipient does not enter college and/or misses the documentation deadline, the scholarship will be returned to the OPC fund and awarded the following year.

·               Students are not eligible to received more than one OPC scholarship. 

 


 

OPERATION POCKET CHANGE SCHOLARSHIP APPLICATION - 1st Year Student

(Applicant must reside within Mountain Electric Cooperative’s service area)

 

NAME                                                                                        BIRTHDATE                                        

                     (Last)                            (First)                         (Middle)

 

SOCIAL SECURITY NUMBER ________________________ PHONE NUMBER                                         

 

MARITAL STATUS:  _____single          married:  NUMBER OF CHILDREN                                               

 

PARENTS/GUARDIANS:

 

NAME(S)                                                                                                                                             

 

MOUNTAIN ELECTRIC COOPERATIVE ACCOUNT NUMBER                                                                  

 

PERMANENT ADDRESS                                                                                                                      

 

                                                                                                                                                           

 

                                                                                                                                                           

 

FATHER'S EMPLOYER, HIS POSITION, ETC.                                                                                        

 

                                                                                                                                                           

 

MOTHER'S EMPLOYER, HER POSITION, ETC.                                                                         

 

                                                                                                                                                           

 

FATHER AND MOTHER GROSS INCOME FOR 2007                                                                             

COPY OF 2007 TAX RETURN MUST BE INCLUDED

 

NUMBER OF DEPENDENT CHILDREN IN FAMILY AND AGE OF EACH                                     

 

                                                                                                                                                           

 

NUMBER IN FAMILY WHO WILL BE IN COLLEGE DURING COMING YEAR                                            

 

LIST REASONS FOR FINANCIAL NEED:                                                                                               

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 


 

GRADE POINT AVERAGE _______________ RANK IN SENIOR CLASS    of                               

 

A.C.T. or S.A.T COMPOSITE SCORE:  ________________________________

(For Community Colleges and/or Technical Schools, A.C.T./S.A.T. scores not required)

 

LIST HIGH SCHOOL HONORS AND AWARDS:                                                                          

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

COMMUNITY, SCHOOL AND CHURCH ACTIVITIES/ACHIEVEMENTS IN LAST FOUR YEARS: 

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

WORK EXPERIENCE (part and/or full-time, include name of supervisor)                                                 

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

PLEASE PROVIDE GENERAL INFORMATION ABOUT YOURSELF, YOUR BACKGROUND, EDUCATIONAL GOALS, PROFESSIONAL ASPIRATIONS, INTERESTS AND OTHER SUCH INFORMATION THAT WILL BE OF BENEFIT TO THE SCHOLARSHIP COMMITTEE:

 

                                                                                                                                                           

 

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

________________________________________________________________________________   

                                                             (Attach extra sheet if more space is needed)

NAME OF COLLEGE YOU PLAN TO ATTEND:  ________________________________________        ____

 

ANTICIPATED COURSE OF STUDY:                                                                                                     

 

HAVE YOU SUMITTED FOR FAFSA? ______, IF NOT, EXPLAIN WHY                                                    

LIST OTHER SCHOLARSHIPS APPLIED FOR AND/OR AMOUNT RECEIVED:                                        

 

                                                                                                                                                           

 

                                                                                                                                                           

 

Applicant must have two letters of recommendations from High School Principal, administer, guidance counselor, teacher or employer.  Letters of recommendations must be submitted with application.

 

PERSONS WHO PROVIDE LETTERS OF RECOMMENDATIONS:

 

NAME _________________________________ OCCUPATION                                                                 

 

ADDRESS __________________________________________ PHONE                                                    

 

NAME _________________________________ OCCUPATION                                                                 

 

ADDRESS __________________________________________ PHONE                                                    

 

IN ADDITION TO THE ABOVE, THE APPLICATION PACKAGE MUST INCLUDE:

 

w        Certified transcript of high school grades.

 

w        Certified college entrance exam (A.C.T./S.A.T.) score (if Required).

 

w        Certification as to rank in high school graduation class.

 

w        Copy of FAFSA Student Aid Report

 

w        Copy of 2007 Tax Return for Parent(s)/Guardian

 

w        A close-up picture (2 1/2" x 3 1/2") of you, which would be suitable for newspaper publication. Please place picture in a marked envelope and attached to application.

 

 

The information provided in this application is true to the best of my knowledge.

 

 

                                                                                                                       

           (Signature of Applicant)                                                                 (Date)

 

 

                                                                                                                                                           

           (Signature of Parent/Guardian)                             (Relationship)                                  (Date)

 

 

SCHOLARSHIP APPLICATION MUST BE RECEIVED BY:  APRIL 22, 2008

 

RETURN TO:  HIGH SCHOOL GUIDANCE COUNSELOR or:        OPC Scholarship Committee                 

                                                                                                              P.O. Box 180

                                                                                                              Mountain City, TN 37683       


 

 

OPERATION POCKET CHANGE SCHOLARSHIP APPLICATION - 2nd - 4th Year Student

(Applicant must reside within Mountain Electric Cooperative’s service area)

 

NAME                                                                                        BIRTHDATE                                        

                     (Last)                            (First)                         (Middle)

 

SOCIAL SECURITY NUMBER ________________________ PHONE NUMBER                                         

 

MARITAL STATUS:  _____single          married:  NUMBER OF CHILDREN                                               

 

PARENTS/GUARDIANS:

 

NAME(S)                                                                                                                                             

 

MOUNTAIN ELECTRIC COOPERATIVE ACCOUNT NUMBER                                                                  

 

PERMANENT ADDRESS                                                                                                                      

 

                                                                                                                                                           

 

                                                                                                                                                           

 

FATHER'S EMPLOYER, HIS POSITION, ETC.                                                                                        

 

                                                                                                                                                           

 

MOTHER'S EMPLOYER, HER POSITION, ETC.                                                                         

 

                                                                                                                                                           

 

FATHER AND MOTHER GROSS INCOME FOR 2007                                                                             

COPY OF 2007 TAX RETURN MUST BE INCLUDED

 

NUMBER OF DEPENDENT CHILDREN IN FAMILY AND AGE OF EACH                                     

 

                                                                                                                                                           

 

NUMBER IN FAMILY WHO WILL BE IN COLLEGE DURING COMING YEAR                                            

 

LIST REASONS FOR FINANCIAL NEED:                                                                                               

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 


 

CURRENT COLLEGE ATTENDING                                                                                                                                           

 

ADDRESS                                                                                                                                                                                         

 

COLLEGE GRADE POINT AVERAGE                              CREDIT HOUR COMPLETED                                    

 

LIST HIGH SCHOOL/COLLEGE HONORS AND AWARDS:                                                                      

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

COMMUNITY, SCHOOL AND CHURCH ACTIVITIES/ACHIEVEMENTS IN LAST FOUR YEARS: 

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

WORK EXPERIENCE (part and/or full-time, include name of supervisor)                                                 

 

                                                                                                                                                           

 

                                                                                                                                                           

 

                                                                                                                                                           

 

PLEASE PROVIDE GENERAL INFORMATION ABOUT YOURSELF, YOUR BACKGROUND, EDUCATIONAL GOALS, PROFESSIONAL ASPIRATIONS, INTERESTS AND OTHER SUCH INFORMATION THAT WILL BE OF BENEFIT TO THE SCHOLARSHIP COMMITTEE:

 

                                                                                                                                                           

 

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                                                                                                                           

                                                             (Attach extra sheet if more space is needed)

NAME OF COLLEGE YOU PLAN TO ATTEND (If different):                                                                    

 

ANTICIPATED COURSE OF STUDY:                                                                                                     

 

HAVE YOU SUMITTED FOR FAFSA? ______, IF NOT, EXPLAIN WHY                                                    

                                                                                                                                                           

LIST OTHER SCHOLARSHIPS APPLIED FOR AND/OR AMOUNT RECEIVED:                                        

 

                                                                                                                                                           

 

                                                                                                                                                           

 

Applicant must have two letters of recommendations from High School Principal, administer, guidance counselor, teacher or employer.  Letters of recommendations must be submitted with application.

 

PERSONS WHO PROVIDE LETTERS OF RECOMMENDATIONS:

 

NAME _________________________________ OCCUPATION                                                                 

 

ADDRESS __________________________________________ PHONE                                                    

 

NAME _________________________________ OCCUPATION                                                                 

 

ADDRESS __________________________________________ PHONE                                                    

 

IN ADDITION TO THE ABOVE, THE APPLICATION PACKAGE MUST INCLUDE:

 

w        Certified college transcript of grades.

 

w        Copy of 2007 Tax Return for Parent(s)/Guardian/Self

 

w        Copy of FAFSA Student Aid Report

 

w        A close-up picture (2 1/2" x 3 1/2") of you, which would be suitable for newspaper publication. Please place picture in a marked envelope and attached to application.

 

 

 

The information provided in this application is true to the best of my knowledge.

 

 

                                                                                                                       

           (Signature of Applicant)                                                                 (Date)

 

 

                                                                                                                                                           

           (Signature of Parent/Guardian)                             (Relationship)                                  (Date)

 

 

SCHOLARSHIP APPLICATION MUST BE RECEIVED BY:  APRIL 22, 2008

 

RETURN TO:  MEC Business Office or mail to:           Mountain Electric Cooperative, Inc.                   

                                                                                    P.O. Box 180

                                                                                    Mountain City, TN 37683

Att: OPC Scholarship Committee