Lineworker Scholarship Application Line Worker Scholarship Application Applicant InformationApplication deadline is June 12, 2021 For questions related to the Line Worker Scholarship program, please contact Sara Thielbar, thielbars@nhec.com, or 603.536.8884Applicant Name First Last Applicant Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneEmail Date of Birth - must be mm/dd/yyyy format MM slash DD slash YYYY NHEC Member InformationName First Last What is your relationship to this member? (if not self) * Required NHEC Account NumberResidence Permanent Seasonal Educational InformationHigh School Name Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Graduation Date - must be mm/dd/yyyy format MM slash DD slash YYYY GED Date - must be mm/dd/yyyy format MM slash DD slash YYYY Line School/Apprentice Program InformationName of Line School/Apprentice Program you are requesting funds for: * Required Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Have you already been accepted into the program? * Required Yes No Accepted Date - must be mm/dd/yyyy format MM slash DD slash YYYY Anticipated Start Date - must be mm/dd/yyyy format MM slash DD slash YYYY Anticipated Graduation Date - must be mm/dd/yyyy format MM slash DD slash YYYY Application Questions:Why do you want to be a line worker? * RequiredTell us about your involvement with sports, activities or clubs. * RequiredOutside of school, what is your favorite hobby or activity, and why? * RequiredIf applicable, please list any work history within the past 5 years. * RequiredUpload your resume (optional)Max. file size: 1 GB.Please list any community activities you have been involved with: * RequiredTell us how you plan to pay for line school. Please include any loans or grants you have obtained or anticipate receiving. * RequiredPlease add any additional information you feel the scholarship committee should know. * RequiredPlease upload (2) Letters of Recommendation * Required Drop files here or Select files Max. file size: 32 MB. Maximum file size - 32 mega bytes. Official High School/GED/College Transcripts * Required Drop files here or Select files Max. file size: 1 GB. Applicant's StatementPlease check the following boxes and acknowledge the following statements: * Required Applicants are not obligated to apply to or work for New Hampshire Electric Co-op upon completion of the lineworker program. New Hampshire Electric Co-op is not obligated to offer scholarship recipients a job upon completion of the lineworker program. No further money will be awarded in the event that an applicant fails to complete the program. In the event that a recipient fails or withdraws from the program, the recipient will be asked to repay the scholarship funds previously received. In the event the recipient withdraws from Line School or the Apprentice Program, the money will be returned to New Hampshire Electric Co-op within three months of resignation. I authorize New Hampshire Electric Co-op to release information announcing my name and town upon receiving a scholarship for publicity purposes. The applicant agrees to the following terms: Applicant's Signature I agree with the above applicant statement.Applicant Name * Required First Last Parent/Guardian Name (if under age 18) First Last CAPTCHA