OKC Tech Connect Form

Student Information

Student ID *

Applicant’s Legal Name

First Name *

Middle Name *

Last Name *

Mailing Address

Address

City

State

Zip

Contact Information

Phone

Email

Career Technology Center Information

Name of career technology center attended

Career technology center program attended

Are you a member of the Oklahoma Chapter of the National Technical Honor Society?

YesNo

Additional Information

Please list special circumstances or financial needs related to your request for scholarship assistance

Please list leadership skills and community involvement