NOMADS Scholarship Form

Name

First NameLast Name

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Email

example@example.com

Phone Number

Area CodePhone Number

Birthdate

MonthDayYear

High School & School District

School Counselor

First NameLast Name

School Counselor Phone Number

Area CodePhone Number

Number in Graduating Class

Class Standing

GPA

Maximum GPA Achievable:

SAT or ACT Total Score

SAT or SAT Verbal Score

SAT or SAT Math Score

Any College Attended:

Years Attended

Current or Intended College Major 1

Current or Intended College Major 2

College Preference 1

College Preference 2

College Preference 3

Have you been accepted to any or all of the above?

Please give us a brief idea of your work history (Dates of employment, Employers Name & Address, the type of work you have done.)

Please give us a brief history of your high school career & recognition (dates of participation or award, type of activity, short description of involvement, offices held, awards received, etc...)

Please give us a brief history of any other out-of-school activities you may participate in (Boy/Girl Scouts, Church, Charity, etc...the years you participated, description of your involvement, offices held, awards received, etc...)

Father's Name

First NameLast Name

Father's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Father's Business Title and Employer Name

Mother's Name

First NameLast Name

Mother's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Mother's Business Title and Employer Name

Sponsoring NOMADS Member:

First NameLast Name

Relationship to Sponsoring NOMADS Member:

Please indicate the yearly income of your family.

Please share any unusual financial circumstances (medical hardships, lay offs, etc...)

List ages of any siblings in High School or College:

Please submit a 500-word essay describing why you should receive this scholarship:

Please upload a headshot of yourself. (Head and shoulders only preferable)

Any scholarship awarded by the Houston Chapter of NOMADS is contingent upon the recipient’s
official registration at an accredited university or college.

Electronic Signature

I, the applicant, for this NOMADS Membership Form, warrant the truthfulness of the information provided in this application.

Please type your first and last name

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

To complete your scholarship application, please do the following.

1. Please mail your most recent official transcript of high school or college record to the address below.

2. Please provide letters of recommendation:

• For High School Student: High School Counselor and High School Teacher or Principal

• For College Student: College professor/dean and Extracurricular activity leader

You can do this by having them email the letter to scholarship@nomads-international.com OR by snail mail to address below or by sending them this link:https://form.jotform.com/70504226064144

NOMADS Int’l (Scholarships)

C/O Power-Flow International Sales, Inc.

1585 W Sam Houston Pkwy N,#200

Houston, TX 77043

NOMADS Scholarship Form - Due June 30