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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
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.
Transcript
Upload your most recent Transcript with your SAT/ACT scores and Class Ranking.
Drop files here or
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