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Gene Fuhrman Scholarship

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Name*
First Last
Nortex Account Name*
First Last
Email*
Phone
Address*
Street Address City State ZIP Code
High School*
College/University
Work Experience
Company Position(s) Held Dates of Employment Average Hours per Week
School and Volunteer Activities
Upload a list of your School and Volunteer Activities detailing the Activity, Position(s) Held, Number of Years Involved and any additional Comments
Drop files here or

Max. file size: 50 MB.
Essay
Describe in 300 words how the internet and/or technology has enhanced your life and education to date and what role it may also play in your future career aspirations.
Max. file size: 50 MB.
Transcript
Upload your most recent Transcript with your SAT/ACT scores and Class Ranking.
Drop files here or

Max. file size: 50 MB.
Please include any additional information you think the reviewing committee should know (i.e family need or hardships overcome)
Applicant Certification*
I Agree
I hereby certify that all of the information in this application is complete and true to the best of my knowledge. I hereby grant permission to Nortex Communications to contact my school for reference if necessary and to use my name and likeness in promotional materials in the event that I am selected.

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Company	Position(s) Held	Dates of Employment	Average Hours per Week