Youth Tour Trip Application

Youth Tour - Trip Application
(Must be a Junior in High School to Apply)

Applicant’s Name*

Address*

City*

State*

Zip*

County*

Phone Number*

Email*

Gender*

Female

Male

Name of School*

Are you currently enrolled as a Junior in high school?*

Yes

Parent Information

Father's Name*

Father's Email*

Mother's Name*

Mother's Email*

Guardian's Name (If not living with Father/Mother)

Guardian's Email

Midwest Energy Account Number*

Applicant Signature

Selection will be made without regard to the applicant's race, color, ethnicity, religion, gender, or physical handicap. Two winners will be selected for the Washington, D.C. trip. Selection is based on the completed application. Children of Midwest Energy employees are not eligible to apply. Applicants will be required to make a presentation of their trip for the Midwest Energy Annual Meeting.

I certify that this information is true, complete and accurate. I authorize release of information to confirm and/or verify this application. I further authorize release of my name in connection with announcements of Youth Tour awards in the event that I am selected to be a Midwest Energy, Inc. Youth Tour recipient.

Applicant’s Signature*

Date*

Parent Release

I/We hereby grant permission for my child to enter the Electric Cooperative Youth Tour competition.

Parent’s Signature*

Date*

Questions

List organizations or clubs in which you have participated.*

What offices have you held in which organizations?*

What honors or awards have you received?*

List your hobbies, talents, and special interests.*

Describe any volunteer experience you have.*

What, if any, work experience do you have?*

Have you ever been to Washington D.C. and, if so, in what capacity?*

What are your future educational and career goals?*

Please write a paragraph describing how you believe your career goals can be realized if you choose to return to central or western Kansas?*

Please write a paragraph explaining what you would hope to learn as a participant in the Electric Cooperative Youth Tour, and how that would support your career plans*