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The deadline for this application is April 30, 2025.

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* 1. Name

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* 2. Date of Birth

Date

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* 4. Phone

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* 5. Address

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* 6. Parent/Guardian Contact Information:

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* 7. School Information

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* 8. Please Attach a Reference Letter (Teacher/Employer/Guidance)

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* 9. Name and year of High School you will be graduating(ed) from:

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* 10. List your school or non-school volunteer/activities in the community:

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* 11. Are you currently working a full or part time job? If yes, please list below:

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

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* 13. Are you or any family members employed within the manufacturing industry? If yes, list this persons name and name of company below:
Are they a member of ManufactureCT?

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* 14. Please tell us what motivated you to apply for this scholarship and how it could help with your future career in the manufacturing industry?

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* 15. I confirm that the information in this application is accurate to the best of my knowledge

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