Scholarship Application Form

Name*
First Middle Initial Last
Physical Address*
Street Address Apt # City State ZIP Code
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Student's Phone Number*
Email*
Please ensure this is a personal email that you check regularly. Do not provide your school email address. We will send correspondence to the address you provide.
Preferred Method of Contact*
Please select ONE option.
- Email
- Cell Phone
- Text Message
Parent/Guardian Name(s)*
Parent or Guardian Contact Number*
High School*
High School GPA*
Name of higher institution you plan to attend:*
Address of higher institution you plan to attend:*
Street Address Apt # City State ZIP Code
Major Field of Study (if known):
Upload a copy of your resume: A resume is required to complete your application. Please contact our office if you have issues uploading your resume.
document types accepted: doc,docx,pdf.
Drop files here or

Accepted file types: doc, docx, pdf, Max. file size: 30 MB, Max. files: 1.
Please write a brief explanation (no less than five sentences but no more than 10) as to why you’d be a good recipient for a Pioneer Electric scholarship.*
I certify that this information is true, complete and accurate. I authorize release of information to confirm and/or verify this application. I further authorize release of my name in connection with announcements of scholarship awards in the event that I am selected to be a Pioneer Electric Cooperative, Inc. Scholarship recipient.
Digital Signature*
- I understand that checking this box constitutes my digital signature of this form.
Confirmation*
- I understand that my application is NOT COMPLETE until I submit this online application, upload my one-page resume and submit my official high school transcript by 12 p.m. on March 5, 2025.
Funds Disclosure*
- I understand that if selected for a scholarship, I will be attending a college or technical school in the fall of 2025. I understand that the funds will be applied to the fall semester only and this scholarship is non-renewable.
Use of Artificial Intelligence Policy*
- I have read Pioneer Electric's Use of Artificial Intelligence policy and understand that my application may be disqualified if found to use generative AI tools in an unauthorized way.
How did you hear about our scholarship?*
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Phone
This field is for validation purposes and should be left unchanged.