Northland Workforce Development Scholarship Application This form is to serve as the official application for Northland Community & Technical College's Workforce Development Scholarship. Name* First Last Student ID (NOT Star ID)Where did you hear about these scholarships?EmailHigh school counselorHigh school eventMailNewspaperNorthland eventNorthland employeeNorthland websiteOnline search (Google)Phone advertisementSocial mediaText messageTV/Video advertisementWeb advertisementWord of mouthOtherCurrent Address* Street Address City State / Province / Region ZIP / Postal Code Country United StatesAfghanistanAlbaniaAlgeriaAmerican 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 Permanent Address* Street Address City State / Province / Region ZIP / Postal Code Email* Date of Birth*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Are you a resident of Minnesota?* Yes No Note: If you are not a Minnesota resident, you do not qualify for this scholarship.What year did you or will you graduate from high school?*Program*Agriculture EducationAnimal ScienceFarm Operations & ManagementGeneral AgricultureArchitectural Technology & DesignAutomotive Service TechnologyAuto Body Collision TechnologyAviation Maintenance TechnologyCarpentryComputer Network TechnologyIT CybersecurityConstruction ElectricityConstruction PlumbingHVACEarly Childhood & ParaprofessionalElectronics Technology - Automated SystemsCriminial JusticeFire TechnologyParamedicHealth Sciences Broad FieldManufacturing Process TechnologyMedical Administrative AssistantMedical Coding SpecialistNursingOccupational Therapy AssistantParamedicPharmacy TechnologyPhysical Therapist AssistantRadiologic TechnicianRespiratory TherapySurgical TechnologyWelding TechnologyThe MN State Legislature has designated nine high-demand program areas for the Workforce Development Scholarship: advanced manufacturing, agriculture, construction, early childhood education, education, health care services, information technology, public safety, and transportation. Please select the program you are pursuing at Northland below. Note: all programs are listed, but not all will qualify for Workforce Development Scholarships.Release to Minnesota StateI hereby authorize the Minnesota State system office to receive and share my contact, academic, and financial aid information with the Minnesota State universities (Bemidji State University, Metro State University, Minnesota State University Moorhead, Minnesota State University Mankato, Southwest Minnesota State University, St. Cloud State University, and Winona State University), for the purpose of informing me of additional available scholarships as I pursue my educational goals.* I agree 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
