GrowthZone Template

Workforce Scholarship Application 2024

Please fill out the application below as completely as possible.

We would like to thank the Community Foundation of Wabash County and the Don Wood Foundation as well as many other generous partners for making this scholarship program possible.

For a full list of upcoming training opportunities taking place in Wabash County, visit https://www.growwabashcounty.com/workforce/workforce-programs

Applicant Information

First Name *

Last Name *

Do you live in Wabash County?* *

Yes No

Do you work in Wabash County? *

Yes No

Are you over 18 years of age? *

Yes No

Address Line 1 *

Address Line 2

City *

Zip/Postal Code *

Cell Phone Number

Work Phone Number (if applicable)

E-Mail Address

Are you eligible to work in the US?

Yes No

Number of members living in Household

1 2 3 4 5 6 7 8 or more

Identify the number of people living in your household including any residents temporarily away from the surveyed family (e.g. college students, persons on extended vacation, etc.)

Number of Family Members in House | Household Annual Income Threshold

	Below	Above
1 person \| $44,200	Below	Above

2 people \| $50,500	Below	Above

3 people \| $56,800	Below	Above

4 people \| $63,100	Below	Above

5 people \| $68,150	Below	Above

6 people \| $73,200	Below	Above

7 people \| $78,200	Below	Above

8+ people \| $83,300	Below	Above

Find the number of household members and the dollar figure that is next to it. Is the employee's family gross yearly income above or below this figure? Your figure should include anyone who contributes their income to the family. If gross annual household income is above, check "above". If it is below, check "below". 1. Income is determined by computing the total income of all family members for the last three (3) months and then multiplying that number by four (4), including persons temporarily away from the family/house. Note: Income is not limited to salaries, wages, and tips. All other forms of income as specified by the Internal Revenue Service should be included (e.g. payments received from social security, pensions, annuities, dividends, taxable interest income, tax exempt interest income, IRA distributions, etc.)

If Other, please specify.

What is your employment status?

Employed Full Time Employed Part Time Unemployed Other

Employer Company Name (if applicable)

Supervisor Name (if applicable)

If your company is sponsoring you to attend program please include your supervisors information.

Supervisor's Email (if applicable)

If your company is sponsoring you to attend program please include your supervisors information.

Will completing training / receiving a certification result in a promotion, pay increase, etc. at your current employer?

Yes No Unsure

What is your level of education?

High School Diploma/ High School Equivalency/GED Certificate degree Some College Associate's Degree Bachelor's degree or more Currently enrolled college or post secondary school Other

If Other, please specify.

Which program are you interested in receiving a scholarship for?

Industrial Maintenance MSSC-CPT Commercial Driver's License (CDL) Certification Computer Numerical Control (CNC) Machining Welding Certified Clinical Medical Assistant Other

If Other, please specify program name, training provider, dates (if known), and estimated cost for program.

Briefly describe your goals after completing this training.

What impact would attending the above training program have on yourself and/or your family? *

Briefly explain why you should be awarded a scholarship.

How did you hear about this program?

Facebook/Social Media Newspaper Radio Referred by Someone Employer Recommended Flyer or Other Ad Grow Wabash County Email/Website Other

If Other, please specify.

A Grow Wabash County team member will be in touch once you submit your application.

If you have any questions contact Chelsea at chelsea@growwabashcounty.com or via phone at 260-563-5258.