Tanner Electric Cooperative

NRECA Youth Tour Application

To be eligible for the Rural Electric Youth Tour to Washington, D.C., the following provisions will govern the acceptance of applicants from Tanner Electric Cooperative (TEC):

-Applicants must have completed their sophomore year, be 16 1/2, be enrolled in their junior year and be a full-time dependent of a TEC member. Home-schooled students are eligible to apply.

-The Youth Tour to Washington, D.C. requires a great deal of physical fitness and stamina, and may not be designed for participants who need significant assistance for personal care, require constant one-on-one support, or have great difficulty managing their behavior in group settings. If your child has a special healthcare need, contact TEC for advance clearance and an evaluation of the traveler's care needs. Health conditions requiring advance clearance include, but are not limited to: insulin-dependent diabetes; cardiac situations; asthmatics; seizure disorders; mental illness; autism spectrum and any serious or life-threatening allergies.

Applications are due by November 1st of the current year.

Student Profile:

*Name of Student:
Nickname:
*Address:
*City:
*State:
*Zip:
*Home Phone Number:
*E-Mail Address:
Enter the email address again for accuracy.
*E-Mail Address:
*Current GPA:
*Date of Birth:	(MM/DD/YYYY)
*Name of High School:
*Name of Parent or Legal Guardian:
*Parent's Cell Phone Number:
*Parent's E-mail Address:
Enter the email address again for accuracy.
*Parent's E-mail Address:
*Tanner Account Number:

Please answer the following questions. Click and drag the bottom-right corner to expand.

List special activities in which you have participated and/or after-school jobs:

What offices have you held in organizations? List any awards and/or accomplishments as well.

What are your hobbies, talents, or special interests?

What are your future plans/goals and how do you plan to achieve them?

Please provide two references from a teacher, employer or coach (one must be from a teacher or guidance counselor). Each section below contains a document upload button; click it to attach a letter of reference or other recommendation document.

First Reference:

*Name:
*Relationship to Applicant:
*Address:
*City:
*State:
*Zip:
*Phone Number:
*E-Mail Address:
Enter the email address again for accuracy.
*E-Mail Address:
*Recommendation Document:

Second Reference:

*Name:
*Relationship to Applicant:
*Address:
*City:
*State:
*Zip:
*Phone Number:
*E-Mail Address:
Enter the email address again for accuracy.
*E-Mail Address:
*Recommendation Document:

Please submit a one page essay for each of the following topics:

*1. What is a 'Cooperative'? How were they established, and what purpose do they serve now?:

*2. Why do you want to attend the Rural Electric Youth Tour and what do you expect to gain from the experience?:

Please upload a wallet-sized photo of yourself:

*Wallet-sized photo:

Please select a tee-shirt size (if selected, we will provide a tee-shirt for you to wear on Youth Day):

*Tee-shirt size:

Small Medium Large XL XXL

Student Acknowledgement:

I hereby ensure that the information provided in this application is true and accurate to the best of my knowledge. I understand the rules as outlined, I must respect and follow the direction of the chaperones, and any deviation from the rules puts me at risk of being sent home at my parents'/own expense.

I will make myself available in November for a personal/phone interview with the Youth Tour Selection Committee at their request.

I understand that, if selected to represent TEC at the Youth Tour, I will be required to attend the TEC annual meeting in May.

I understand that, if I am selected and due to unforeseen circumstances/reason I am not able to fulfill my obligation to attend the tour, I must notify TEC immediately so an alternate may be arranged.

Click here to draw your signature.

Applicant's Signature

With your mouse, draw your signature. Then click Finish.

Date: (MM/DD/YYYY)

Parent Acknowledgement:

The Rural Electric Youth Tour to Washington, D.C. requires a great deal of physical fitness and stamina, and may not be designed for participants who need significant assistance for personal care, require constant one-on-one support, or have great difficulty managing their behavior in group settings. If your child has a special healthcare need, contact the TEC Youth Tour staff for an evaluation of the student's care/needs. Health conditions requiring advance clearance include, but are not limited to, insulin-dependent diabetes; cardiac situations; asthmatics; seizure disorders; mental illness; autism spectrum and any serious or life-threatening allergies.

I have read and understand the above statement and assure trip administrators that, if selected, my son/daughter meets the health, physical and behavior requirements as noted and is eligible to participate in the Youth Tour to Washington, D.C.

I acknowledge that failure to provide TEC with a minimum of 45 days cancellation notice could result in a participant's parents being billed for all or a portion of the trip's expenses that are non-refundable.

Click here to draw your signature.

Parent or Guardian Signature

With your mouse, draw your signature. Then click Finish.

Date: (MM/DD/YYYY)