Student InformationStudent's Name(Required) First Last (Required) Date of Birth Age Grade School(Required) School District(Required) I have been accepted, and will be attending a:(Required) College or University Vocational or Trade School Name of College/University/Vocational School(Required) Desired Field of Study or Major(Required) Membership InformationName of Parent/Legal Guardian, who is a member of RGEC (as it appears on electric bill)(Required) First Last RGEC Account Number(Required) Address(Required) Street Address City State Zip Phone(Required)Email(Required) (Please use a personal, non-school address, as correspondence will continue after graduation)Please tell us about yourself. Include hobbies, volunteer work, organizations, etc.(Required)Referances to family names, specific location, or information that might reveal the identity of the applicant must not be included in the body of the essay. Doing so could result in disqualification. I am applying for this scholarship in order to:(Required)If selected as an RGEC scholarship recipient, I hope to use my education to benefit rural America by:(Required)Which of the 7 Cooperative Principles do you feel is the most important, and why?(Required)Applicant Photo(Required)Max. file size: 150 MB.Please attach a high resolution photo. A school photo is preferred. Consent(Required) I certify the attached to be my own original work, and that I did not plagiarize another source, nor did any other person compose this entry for me. I understand that my photograph may be posted in magazines and/or newspapers, RGEC’s website, and social media pages. I agree to abide by the decision of the judges in all matters pertaining to the contest and the awarding of scholarships.Applicant's Electronic Signature(Required) Parent/Legal Guardian's Electronic Signature(Required) (Note: Parent/Legal Guardian must be the authorized representative of the account)EmailThis field is for validation purposes and should be left unchanged.
