Form A/B ← Back to Scholarship Forms E-Application Form A/B Form A/B collects personal, school, employment and community activity information. This form must be completed by all scholarship applicants. Name* First Last Middle Initial Email* Age*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*High School* I am applying for the following scholarships* Frank C. Heinisch Memorial Scholarship, OEA Foundation Presidents, OEA Foundation, Kriebs, Clark (also submit Form C1) Neale, Williams (also submit Form C2) Seward (also submit Form C3) Bavaresco (also submit Form C4) Bethel (also submit Form C5) Dodd (also submit Form C6) Engelhart (also submit Form C8) Fields (also submit Form C10) Gyger (also submit Form C12) Hotz (also submit Form C13) Bradley (also submit Form C14) Pilster (also submit Form C15) Parrish, Sedlak (also submit Form C16) MAT (also submit MAT Form) Theta Phi Delta (also submit Theta Phi Delta Form) Check all that applyFather's (or Guardians) name First Last Father's Place of Employment Mother's (or Guardians) name First Last Mother's Place of Employment Other children in my family - Names and AgesCurrent Senior High School* High School Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Other Senior High SchoolsPlease list any other Senior High School attended, please include addresses.Junior High Schools*Please list all Junior High Schools attended. Please include addresses.Elementary SchoolsPlease list all Elementary Schools attended. Please include addresses.High School Graduation Date* MM slash DD slash YYYY School ActivitiesList up to 5 extra curricular activities and the grades which apply.EmploymentPlease list last 2 employers, job duties, and dates of employment,Community ActivitiesPlease list up to 4 activitiesWhat are your goals?*What career opportunities do you plan to pursue and why do you need a post-secondary education?Have you been accepted by a post-secondary institution?* Yes No If yes, please list the name and address of the institution. SAT scoreACT scoreAttachmentsTranscriptMax. file size: 128 MB.Click here to attach a copy of your transcript of grades through the first semester of your senior year. Transcripts can be uploaded or a hardcopy can be mailed. All uploaded documents must be a Microsoft Word 2003 document or a PDF file.First letter of recommendation - principal, a counselor, or teacherMax. file size: 128 MB.Click here to attach a letter of recommendation from your principal, a counselor, or teacher. Letters of recommendation can be uploaded or a hardcopy can be mailed. All uploaded documents must be a Microsoft Word 2003 document or a PDF file.Second letter of recommendation - employer or another adultMax. file size: 128 MB.Click here to attach a letter of recommendation from your employer or another adult. Letters of recommendation can be uploaded or a hardcopy can be mailed. All uploaded documents must be a Microsoft Word 2003 document or a PDF file.Your PictureMax. file size: 128 MB.Click here to upload a picture of yourself. Your uploaded picture should be a jpg file. Be sure to have the file on a cd or flash drive if you use a school computer.Please be certain you are eligible for the scholarships for which you are applying.By entering the confirmation code I verify the following: I have requested that the following be sent directly to the OEA Foundation, or I have downloaded the information herein, or I will mail hard copies to the OEA Foundation: 1) A transcript of grades through the first semester of my senior year. 2) A letter of recommendation from my principal, a counselor, or a teacher. 3) A letter of recommendation from my employer or other adult. - I understand that incomplete applications will result in ineligibility for any scholarship. If you agree, and have completed all of the above, please enter the confirmation code and submit this form. Thank you. - Hard copies should be mailed to: OEA Foundation, 4202 South 57th Street, Omaha, NE 68117, (402) 346-0400, (402) 393-7998 or (402)740-7911 - Linda Richter Captcha
