Rock Energy Co-op Scholarship Program
Scholarships for 2009 High School Graduates
Deadline for application receipt is January 9,2009
We're pleased to announce that once again the Cooperative will be able to award scholarships to high school seniors graduating in 2009 who plan on attending an accredited college or technical school.
Past scholarship recipients have received up to $400.00 to put towards future endeavors.
Applicants must be living within the Rock Energy Cooperative's service territory. The following application had to be completed and submitted along with your senior picture before January 9, 2009
Applications are available at your high school guidance office and at the Rock Energy Cooperative's offices at 2815 Kennedy Rd, Janesville, WI and 238 Charles St. South Beloit, IL.
Or you can copy and print selection from the application below. Please note that trying to fill it out on this page will not get it to us.
ROCK ENERGY COOPERATIVE
2009 SCHOLARSHIP APPLICATION
(TO BE FILLED OUT BY STUDENT)
Name:_____________________________ Date of Birth: _____/_____/_____
Home Phone # (___)_____-______ High School Attending:
Home Address (City, State, Zip):
Rock Energy Cooperative Account Number:
Father’s Name:_______________________ Occupation:
Mother’s Name:______________________ Occupation:
Number in Household:________________ # currently in post high school education:
Name of school you will attend next year:
Majors & Minors you intend to pursue:
Total cost of school minus any contributions from you and your family (per yr.):
On a separate page(s) please answer the following:
- List high school clubs, community activities, and any job experiences you have been involved in. Please give dates and any offices or positions held.
- What field(s) are you planning to study and why?
- In your own words describe the function of a cooperative, and the advantages that it offers its members. List any experiences you have had with the cooperative. (minimum of two paragraphs in length).
- Briefly give any other information that you feel is pertinent to this application.
Please read and sign this statement:
I give my permission to release this application and a transcript of my high school records to any appropriately designated local scholarship committee.
Signature:__________________________ Parents Signature:
(If applicant is under 18)
This form must be completed and returned with a senior picture by January 9, 2009.
Incomplete applications will not be considered.
ROCK ENERGY COOPERATIVE
2009 SCHOLARSHIP APPLICATION
(TO BE FILLED OUT BY THE PRINCIPAL OR COUNSELOR)
Date:______________________
Applicant’s Name:
Applicant’s Address:
Name of high school:
Applicant’s rank in class:_____________________
Number in graduating class:___________________
Test Scores (please list test name and how they rank in the state percentiles)
Please include additional comments at this time:
Date & Time of Awards Ceremony
Your Signature:_________________________ Title:
Guidance Office Phone (ext. # if any):
Please attach a copy of student’s transcripts with this form.
This form must be completed and returned with the Student’s copy by January 9, 2009.

