Youth Tour Application

To be eligible to be selected for the Youth Tour to Washington, D.C., you must:

Be a high school sophomore, junior.
Be a child or legal ward of a member of Buckeye Rural Electric Cooperative, Inc. and living in a home served by the cooperative at the time of the tour.
Include a school transcript indicating cumulative GPA
Include a letter of recommendation from a guidance counselor, principal, teacher or community or organizational advisor.
Complete a test consisting of true/false and short essay questions about rural electrification. The test will be given once your application has been received; you will be contacted to schedule a testing time and location (if other than the cooperative office). Cooperative knowledge questions will be based on the Online Orientation course and Electric Co-ops and the Seven Cooperative Principles, located at www.ohioec.org/orientation. Students are recommended to complete this course prior to taking the test. The course takes approximately one hour to complete.

First Name

Middle Name

Last Name

Preferred Name

Phone Number

Student's Email

Address

City

Zip Code

Birthdate

Gender

Male

Female

Birthplace

City, state, zip code, county

High School

School Address

Street address, city, state, zip code

Year in School

Sophomore

Junior

BREC Account Number

Parent/Guardian Name(s)

How names should be listed for press release

Parent/Guardian(s) Cell Phone Number(s)

Emergency Contact Information (if parent/guardian can't be reached)

Include name, phone number, relationship to student

Personal Achievement

School and other activities

Re-order	Organization/Activity	# of Years	Comments	Weight	Operations
	Organization/Activity	# of Years	Comments	Item weight

more items

Why do you want to participate in the Youth Tour to Washington, D.C.?

Please limit your answer to 150 words.

High School Transcript

Must include cumulative GPA
One file only.
20 MB limit.
Allowed types: txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods.

Letter of Recommendation

From guidance counselor, principal, teacher, or community or organizational advisor

One file only.
20 MB limit.
Allowed types: txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods.

Statement of Applicant, Parent/Guardian

We have examined this application and the records are true, complete, and accurate.

Applicant Signature

Sign above

Parent/Guardian's Signature

Sign above