• Complete all applicable items. Type or print legibly.
• Application must be completed each semester. (Maximum of two (2) semesters per calendar year).
I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of
facts called for in this application may be cause for denial.
Related Training Program is Approved by the North Dakota State Electrical Board?
☐ No ☐ Yes – Provide North Dakota State Electrical Board Course Approval Number
All of the Following Requirements Must Be Met to Apply for Related Training Scholarship Funds
1. Record Providing Proof of Purchase of Education Materials for the Current Year’s Classes.
2. List of Apprentices Enrolled Per Semester in Related Training Program – See Page 2.
3. The Apprentice is a Resident of North Dakota. Provide a Complete Address - See Page 2.
4. The Apprentice Works in the Jurisdiction of the North Dakota State Electrical Board.
5. The Apprentice is Employed by a North Dakota Based Electrical Contractor – See Page 2.
6. The Apprentice Continuously Has Been Registered with the North Dakota State Electrical Board.
7. The Apprentice is Enrolled in a Board Approved Related Training Electrical Apprenticeship Program.
8. The Apprentice Must Have and Maintain a Minimum of a 2.5 Grade Point Average from the Previous Semester
(Including Incoming from High School) – See Page 2.
9. If an Apprentice Fails a Semester, Funds will not be Available for the Apprentice Until a 2.5 Grade Point Average is