NCTC Early Recruitment Scholarship Application This form is to serve as the official application for Northland Community & Technical College Early Recruitment Scholarship opportunities. Name* First Last Student ID (NOT Star ID)Current Address* Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Cell Phone*Email* What year will/did you graduate from high school?* Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender* Female Male Other Prefer not to identify Enrollment status for fall* Full-time - 12+ credits Part-time - less than 12 credits Program*AccountingAccounting Clerk - Microcomputer Applications EmphasisAdministrative Office SpecialistAdministrative ProfessionalAnimal ScienceArchitectural Technology & DesignComputer Aided DesignAutomotive Service TechnologyAuto Body Collision TechnologyAviation Maintenance TechnologySmall Unmanned Aircraft Systems TechnicianBusinessCarpentryComputer & Network TechnologyCommercial Vehicle OperatorConstruction ElectricityConstruction PlumbingHVACCriminial JusticeCustomer ServiceDietetic TechnicianEarly Childhood & ParaprofessionalElectronics Technology - Automated SystemsFarm Operations & ManagementFirefighter ParamedicFire TechnologyAgriculture EducationHealth Sciences Broad FieldGeospatial Intelligence AnalysisImagery AnalysisLiberal ArtsManufacturing Process TechnologyAutomation TechnologiesMachine TechnologyProduction TechnologiesWelding TechnologyMedical Administrative AssistantMedical Coding SpecialistNursingNursing AssistantPractical NursingOccupational Therapy AssistantParamedicPharmacy TechnologyPhlembotomyPhysical Therapist AssistantPrecision Agriculture Equipment TechnicianRadiologic TechnicianRespiratory TherapistDigital MarketingSales, Marketing & ManagementSupervisory LeadershipSurgical TechnologyUndecidedNote for liberal arts students: Three general liberal arts pathways are offered at Northland. If you plan to pursue employment or a four-year degree in a specific academic field within the Liberal Arts (ex. Social Work, Biology, Journalism), please indicate that in the box below.Planned liberal arts focus (if any) Degree/certificate* AS AAS Diploma AA Certificate EmploymentAre you employed?* Yes No If yes, how many hours per week?ActivitiesList extra-curricular activitiesList high school and college separatelyList community and/or volunteer activitiesLong Answer Section500 word limitPlease respond to the following items in an essay of fewer than 500 words. a) Describe your service to family, community, clubs, organizations, employers, and others. Note any special leadership roles or awards received. b) Describe your interest in the program/degree you have chosen. c) Describe your long-range educational goals and career plans. List the college activities in which you intend to participate at Northland. d) Describe any other life experiences, financial issues, or unusual circumstances you have had that may impact your need for a scholarship. Certification I have read all the terms and conditions for the NCTC Foundation Scholarship program. I understand the NCTC Foundation is asking me to provide information that includes private and/or confidential information under state and/or federal law including access to my transcripts, test scores, and enrollment records held by Northland. I am not legally required to provide the information. However, I understand the NCTC Foundation may not be able to effectively process my application if I do not provide sufficient information and access to my records. I certify that the information on this application is true and correct to the best of my knowledge and grant my permission for the information contained herein to be shared with the NCTC Foundation Scholarship Committee, NCTC Foundation Executive Committee, NCTC Foundation Board of Directors, and any third parties deemed necessary, along with information from Northland's Student Services, Academic Affairs, and the Business Office. If awarded an NCTC Foundation scholarship, I must meet and maintain all eligibility requirements. If awarded an NCTC Foundation scholarship, I release to the NCTC Foundation the right to use my name and picture for publications, reports, and press releases. I also agree to write a letter of appreciation to the contributor of the scholarship and attend the NCTC Foundation Scholarship Ceremony. If unable to attend the ceremony, special circumstances can be considered by the NCTC Foundation Office. I agree that it is my responsibility to contact the Foundation Office regarding my attendance at the scholarship ceremony. * I agree