Application for the SAGE Staffing/Work Experience

Scholarship

Name: _________________________________________________________________________

Address: _______________________________________________________________________

______________________________________________________________________________

Phone Number: _____________________________________

E-mail Address: _____________________________________

Overall G.P.A.: _________________

Semester you were enrolled in Work Experience: ____________________________________

Are you planning on attending college or a trade school? ____________________

School: ________________________________ Major: ___________________________________

What are your career goals? _________________________________________________________

_________________________________________________________________

Employment History

Please provide all employment information for your past three employers starting with the most recent.

Employer: _______________________________________ Position Held:__________________________

Address: ______________________________________ Telephone: _________________________

______________________________________________

Immediate Supervisor and title: ________________________________________________________

Dates employed: From _______________________ to: ______________________ Salary: ________________

Job Summary: ____________________________________________________________________

Other Skills and Qualifications

Summarize job-related training, skills, certificates, and other qualifications. Include volunteer work, internships, special courses and or seminars you have participated in.

 

 

 

Required Signatures

Your signature: ______________________________________________________

Parent/Guardian: _____________________________________________________

Work Experience Teacher ___________________________________________

Dr. Priesz, Principal _________________________________________________