2025 Gene Fuhrman Scholarship Name* First Last Nortex Account Name* First Last Email* PhonePhysical Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code High School*College/UniversityWork ExperienceCompanyPosition(s) HeldDates of EmploymentAverage Hours per Week School and Volunteer ActivitiesUpload a list of your School and Volunteer Activities detailing the Activity, Position(s) Held, Number of Years Involved and any additional Comments Drop files here or Select filesMax. file size: 50 MB.EssayIn 300 words, describe how the internet and/or technology has enhanced your life and education and how they, along with this scholarship, could support your future career goals. Drop files here or Select filesMax. file size: 50 MB.TranscriptUpload your most recent Transcript. Drop files here or Select filesMax. file size: 50 MB.Please include any additional information you think the reviewing committee should know (i.e family need or hardships overcome)*Applicant Certification* I AgreeI hereby certify that all of the information in this application is complete and true to the best of my knowledge. I hereby grant permission to Nortex Communications to contact my school for reference if necessary and to use my name and likeness in promotional materials in the event that I am selected.CAPTCHA
