Scholarship Application Form for High School Students: Merit Scholarship B

NAME: _________________________________________________ DATE: _______________

TEMPORARY ADDRESS: _______________________________________________________________

PERMANENT ADDRESS: _______________________________________________________________

TEMPORARY PHONE NUMBER: ______________ PERMANENT PHONE NUMBER: _____________

NDTA MEMBERSHIP NUMBER OR NUMBER OF SPONSOR: ________________________________

IF APPLICABLE, NAME OF SPONSOR: ___________________________________________________

(note: must be a dependent of an NDTA member as defined by IRS code)

ACADEMIC ACHIEVEMENTS: Attach the following documents to this application:

1. High School Transcripts

2. ACT/SAT Scores

3. Resume (to include work experience, education, extra-curricular activities and honors/awards)

4. A 300-500 word personal statement (may include career goals, why you are the best candidate for the scholarship, an essay on the importance of transportation and logistics, etc…)

ACADEMIC GOALS:

Please list the schools have you applied to (indicate if you’ve been accepted):

___________________________________ __________________________________

___________________________________ ___________________________________

What do you plan to study? _______________________________________________________________

Note: NDTA scholarship funds are forwarded to the institution where an applicant is enrolled. Before funds are released, the successful applicant must submit documentation showing that he/she has in fact been accepted as a student by the institution.

I hereby certify that the information above is true to the best of my knowledge.

Signature of Applicant: ___________________________________________________________________

Note: Please mail in this application and all attachments in a sealed envelope to PO Box 02060 Dover DE 19902 postmarked no later than 15 June 2007.