OHIO GAS ASSOCIATION SCHOLARSHIP FOUNDATION 2018 SCHOLARSHIP APPLICATION GUIDELINES

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OHIO GAS ASSOCIATION SCHOLARSHIP FOUNDATION 2018 SCHOLARSHIP APPLICATION GUIDELINES SCHOLARSHIP INFORMATION Applications are accepted between January 15, 2018 and March 16, 2018 Scholarship winners will be announced in April 2018 $1,000 annual scholarship may be renewed up to three additional years. If qualified, renewal application must be completed annually during application period. Scholarships are limited to undergraduate college studies, technical or trade school programs. MINIMUM APPLICANT CRITERIA Must be a U.S. citizen or legal resident. Must have a career goal in the crude oil and natural gas industry, or related energy field. Must be an OHIO resident attending, or planning to attend an accredited OHIO college, university, technical, or trade school. Must have and maintain a grade point average (G.P.A.) of 3.0 or higher. SUBMISSION REQUIREMENTS Completion of three-page application, signed and dated. Two letters of recommendation from a teacher, employer or other mentor figure. Note: Recommendations from family members are not acceptable An essay consisting of no less than 250 words, and no more than 500 words, describing personal and career goals, academic achievements, extracurricular activities, awards/recognitions, community service, work history, financial needs, and personal or family influences.

High School or College, Trade School or Technical School Transcript for highest level of education received ACT and/or SAT test scores, if applicable. RETURN COMPLETED FOUR-PAGE APPLICATION WITH ATTACHMENTS NO LATER THAN MARCH 16, 2018. Information received after this date will render the application incomplete and it will not be processed. RETURN APPLICATION TO: Ohio Gas Association Scholarship Foundation Attn: Scholarship Awards 137 E. State Street Columbus, OH 43215 Phone: (614) 545-6307 www.ohiogasassoc.org

PAGE 1 PERSONAL INFORMATION Full Name: Date of Birth (MM/DD/YY): Male Female Are you a U.S. Citizen or legal resident living in Ohio? Yes Primary Mailing Address: Home School Parent/Guardians House Street Address: Apt #: City: State: Zip Code: Secondary Mailing Address (if needed): Home School Parent/Guardian s Home Street Address: Apt #: City: State: Zip Code: Primary Phone: Secondary Phone: Email: Are you currently a student? Full-time Part-time No Are you currently working? Full-time Part-time No Are you currently enlisted in the military or a veteran? Yes No

PAGE 2 Have you previously applied for an OGA scholarship? Yes No If Yes, what year(s)? How are you funding your education? (Check all that apply): Personal Income Scholarships Financial Aid / Grants Student Loans Parent/Guardian Income Other (Please Specify) FAMILY INFORMATION Father s Employment/Occupation: Deceased Mother s Employment/Occupation: Deceased Do you have any other siblings currently attending college? Yes No

PAGE 3 EDUCATIONAL INFORMATION FOR HIGH SCHOOL STUDENTS ONLY Career Goal: High School Name: City: State: GPA: Anticipated Date of High School Graduation (MM/YY): ACT Test Score (if applicable): SAT Test Score (if applicable: Transcript and Essay Attached? Yes No If No, explain reason: College, University, Technical or Trade School Enrolled: City: State: Major or Field of Study: If Not Enrolled, Explain Status of Admission and Reason:

PAGE 4 EDUCATIONAL INFORMATION FOR COLLEGE/TECHNICAL OR TRADE SCHOOL STUDENTS ONLY Career Goal: College, University, Technical or Trade School Attending: City: State: Major or Field of Study: GPA: Anticipated Date of Graduation (MM/YY): ACT Test Score (if applicable): SAT Test Score (if applicable: Transcript and Essay Attached? Yes No If No, Explain Reason: SIGNATURE OF APPLICANT I certify that all information is true and accurate. I authorize independent verification. I understand that if I am awarded an OGA Scholarship, information contained in this application may be released to the media. Signature of Applicant: Date: