NTRI Technical Scholarship Application

Name:   Last  ________________________  First  __________________  MI  _______ 

Phone: (     )   _______________________  Social Security Number  ____________________

Address:  __________________________________________________________

City:  ______________________   State:  ____________  Zip:  ______________

Intended Program:  _________________________  Part-time ___  Full-time ___

Educational Background of Student
Name of School Attended/Attending (in chronological order)	Type of School (Primary, Secondary, etc)	Date Joined (DD/MM/YYYY)	Date Left (DD/MM/YYYY)	Credits Earned

Please list any extracurricular activities you were involved in:

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In a brief narrative, please explain how and why this scholarship would be beneficial to you in reaching your educational goals.

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I certify that all information contained in this application is correct and complete to the best of my knowledge. I understand that withholding and/or giving false information on this application may make me ineligible for the scholarship.

Signature _____________________________   Date:  _____________________________

Please return Application directly and two reference letters (non-related persons) submitted on your behalf to:

Network Technology Resources
One Kiski Avenue
Leechburg, PA 15656
Attention: Scholarship Review Board

Note:  Your reference letters must be received before your application for a scholarship can be considered.