Professional Technical Application Form

Applicant First Name

Applicant Last Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email

Phone Number

Parental information is not required of adult, non-dependent applicants. If adult applicant is married, spouse’s information must be included.

Parents’ or Spouse’s Name(s)

Father or adult applicant's place of employment

Mother or Spouse’s place of employment

High School Diploma

Yes

No

GED

Yes

No

GPA

Please list all (if any) post-secondary institutions attended

Are you currently attending school? Current enrollment is not required to apply.

Yes

No

If yes, where?

If no, where and when did you last attend school?

What post-secondary institution do you plan to attend?

What program do you plan on enrolling in?

What is the program length (in years or semesters)?

What are the estimated total tuition and fees (not including room and board)? $

What date do you plan to attend that post-secondary institution?

Loans: $

Scholarships or Grants: $

Total gross income for household $

Number of family members residing in household

Other factors which influence financial need

What is your understanding of KEC's Operation Round Up program (describe in your own words)?

Please attach the following:

High school transcript or current college transcript (last two years). Attach explanation if not available.

One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Provide a one-page essay (up to 400 words, double-spaced with 12-point font). In the essay, tell us about yourself (such as: interests, background, hobbies, interesting experiences) and who/what has influenced your selection of the technical/professional vocation.

One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Two letters of recommendation.

Letter of recommendation #1

One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Letter of recommendation #2

One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Applicant's Signature

Sign above

I certify that all information reported on this application is true and correct to the best of my knowledge. (Proof of financial information and student id may be required if scholarship is awarded.)

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