Current Highschool Seniors

To the Applicant (Must be a 2023 High School Senior)

You MUST complete this application online at ndgrocers.com/scholarships/ After completing the application online, print and acquire all needed signatures. If you need more space for supporting documents, they MUST be typed.

Complete the sections of this application and forward to:

NDGA, Bronson Scholarship, 3155 Bluestem Dr. #378 West Fargo, ND 58078, or Scan to [email protected]

You are responsible for seeing that this application is complete when submitted. NDGA and its affiliate programs reserve the right to process only applications found to be complete as of the application postmark deadline of March 17, 2023.

Remember:

You must be presently employed in the supermarket/grocery industry of a NDGA member and have been so far for at least one (1) year. -OR-
One or both of your parents or legal guardians must be presently employed in the supermarket/ grocery industry of a NDGA member and have been so far for at least two (2) years.
Be Attending a Vocational College or University in Fall of 2023

CERTIFICATION AND PERMISSION TO USE “RECIPIENT INFORMATION” TO ANNOUNCE SCHOLARSHIP WINNERS

In submitting this application, I certify that the information provided is complete and accurate to the best of my knowledge. Falsification of information may result in termination of any scholarship granted. I agree that if I am offered and accept an award from the North Dakota Grocers Association, the Association may use my name, the name of my community, the name and address of my school, the amount of the award, and the name of the post-secondary institution. I will attend (my “recipient Information”) in press releases, public announcements, and other fundraising or promotional materials in all media (including the internet.)

Applicant's Signature(Required)

Date(Required)

Parent's Signature

(if student is under 18 years old)

Store Name(Required)

Location(Required)

Manager/Owner Name(Required)

Phone(Required)

Email(Required)

BRONSON SCHOLARSHIP APPLICATION

2021-2022 ACADEMIC YEAR

Instructions

Must include email address- All communications will be made via email
High School students are eligible if meet all criteria (See page 1)
Deadline: Completed applications must be Submitted by March 18, 2022

Student Name & Contact Information

Name of Applicant(Required)

First Last

Street Address(Required)

Street Address Address Line 2 City State ZIP Code

Cell Phone

Home Phone

Email(Required)

Parent/Guardian Contact Information

Name of Parent/Guardian

First Last

Street Address

Street Address Address Line 2 City State ZIP Code

Cell Phone

Home Phone

Email

If employed by a North Dakota Grocers Association Member Business complete the following:

Occupation

Years of Employment

Place of Employment

City

State

Owner/Manager Name

Phone

Scholarship Criteria

Award Winners will be determined by the NDGA Scholarship selection committee. All students, parents and employers information are required prior to submission to selection committee. The selection committee evaluates the following criteria for students applying for the Scholarship:

Academic Achievements - 25
Leadership/Extra Curricular Activities/Work experience - 30
Essay - 20
Education/Employer Letter(s) of Recommendation - 25

Scholastic Information

High School(Required)

Date(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Name of School Official

Position

Phone

Email

Current Official School Transcript(Required)

Drop files here or

Max. file size: 100 MB.

ACT or SAT Score(Required)

GPA(Required)

Post Secondary School Information

School You Plan to Attend in the Fall:(Required)

Secondary School Type

Technical College/Trade School

College/University

Address

Street Address Address Line 2 City State ZIP Code

Your Major Field of Study

Academic Record and Achievements

List of Honors/Awards You Have Received

List of Offices or Leadership Positions You Have Held; Include Name of Organization

List Other Extracurricular Activities and/or Community Service in Which You Have Been Involved

Student Essay

What Are Your Career Goals (Short-Term & Long-Term) After Completing Your Education?

Why Are You Deserving of This Scholarship?

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NDGA Highschool Scholarship

CERTIFICATION AND PERMISSION TO USE “RECIPIENT INFORMATION” TO ANNOUNCE SCHOLARSHIP WINNERS

BRONSON SCHOLARSHIP APPLICATION

2021-2022 ACADEMIC YEAR

Student Name & Contact Information

Parent/Guardian Contact Information

Scholarship Criteria

Scholastic Information

Post Secondary School Information

Academic Record and Achievements

Student Essay