SAN MIGUEL POWER ASSOCIATION / TRI-STATE GENERATION & TRANSMISSION SCHOLARSHIP APPLICATION

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1 SAN MIGUEL POWER ASSOCIATION / TRI-STATE GENERATION & TRANSMISSION SCHOLARSHIP APPLICATION By completing this application, you are applying for both the $2000 San Miguel Power Scholarship (one per school) and the $500 Tri-State Scholarship (two for all six schools (Telluride, Ouray, Ridgway, Silverton, Norwood, Nucla). Applicants planning to pursue a degree in an energy-related field of study (See addendum for list of acceptable subjects) may also complete the addendum to apply for the Wes Perrin $2,500 four-year renewable Memorial Scholarship ($10,000 Total). Return completed form(s) to: SMPA Scholarship Committee Attn: Alex Shelley PO Box 1150 Ridgway, CO Application Deadline: February 5, 2016 Please note: late applications will not be considered. Applicant Name: Current Mailing Address: Phone: Parent/Guardian Name & Address: APPLICANT INFORMATION SMPA Account Number: High School (name & address): SAT Cumulative Score (if applicable): Rank in High School (if applicable): High School GPA: ACT Cumulative Score (if applicable): Number of Students in Graduating Class: Date of Graduation:

2 EXTRACURRICULAR INFORMATION Please complete the following questions. Be specific. If necessary use a separate sheet of paper (you will be judged on the neatness of your application). 1. Please list any scholarships you have been notified of receiving. 2. List your extracurricular activities. Include your athletic, academic, community, and volunteer activities, as well as positions you hold. 3. List any special awards, recognitions, or achievements you have received. 4. Describe your immediate and 5-year educational and/or vocational goals. 5. Statement of Need: College is expensive. Describe why you need this scholarship. Please be specific.

3 REQUIRED ATTACHEMENTS Attach the following items with this scholarship application. You will lose points for missing items. - One letter of recommendation - Official high school transcripts to 500 word essay describing the value of your local electric cooperative, San Miguel Power Association to your family and your community. (See for a list of research resources.) SIGNATURE I understand that the information in this application and all supporting documents become the property of San Miguel Power Association, Inc., and may be released to sponsors or other persons responsible for the administration of financial aid. By signing this application, I am aware that this scholarship will be presented at the time of graduation and announced at the Annual Meeting of San Miguel Power Association, Inc. Date: Signature: STOP NOTE: If you don t intend to apply for the Wes Perrin Memorial Scholarship, you are done.

4 ADDENDUM: THE WES PERRIN MEMORIAL SCHOLARSHIP In memory of SMPA Board Director, James Wes Perrin, who passed away from throat cancer in the spring of 2013 and the contributions he made to San Miguel Power Association, this scholarship will be awarded to one deserving candidate who is a dependent of a San Miguel Power member living in the service territory, is completing his/her senior year of high school and intends to pursue an education and career in the energy industry. Successful candidates must demonstrate a passion for the industry, as well as pursue a degree in the energy field. Amount: $2,500 four-year renewable ($10,000 in total) Requirements: All items in this addendum must be completed and submitted along with the completed San Miguel Power Association / Tri-State Generation & Transmission Scholarship Application. Eligible applicants must be pursuing a degree in one of the following subjects: Biotechnology Nuclear Engineering Chemistry Petroleum Engineering Physics Technology Engineering Electrical Lineworker Schools & Programs Hydroelectric Power Technology Chemical Engineering Solar Energy Technology Civil Engineering Construction Engineering Energy Engineering Environmental Engineering Mechanical Engineering Mining Engineering For complete eligibility requirements, refer to the Wes Perrin Memorial Scholarship Guidelines and Eligibility Requirements (attached). Return completed addendum along with SMPA / Tri-State scholarship application to: SMPA Scholarship Committee Attn: Alex Shelley PO Box 1150 Ridgway, CO Application Deadline: February 5, 2016 Please note: late applications will not be considered. Wind Energy Technology Other (Applicant is fully responsible for demonstrating how their field of study is directly related to the energy industry and their intended career path.)

5 Institution Name: Mailing Address: INTENDED COLLEGE, UNIVERSITY, OR TRADE SCHOOL Phone: Intended Major Course of Study: Additional Study: Dual Major? or Minor? Intended Career: Have you been accepted into this school and/or field of study? Yes Not yet COLLEGE ENTRANCE EXAM(S) SAT Cumulative Score (if applicable): SAT Verbal: SAT Math: ACT Cumulative Score (if applicable): ACT English: ACT Math: ACT Reading: ACT Science: List any college credits already earned: REQUIRED ATTACHEMENTS In addition to the items required with the SMPA/Tri-State scholarship application, please attach the following: (You will lose points for missing items.) - One additional letter of recommendation - Official copy of your college entrance exam scores (all that apply) - A 500 word essay demonstrating your passion for the energy field and your plan for achieving your goal of working in the industry. This essay is important. Please be specific about your educational and career goals. SIGNATURE I understand that the information in this application and all supporting documents become the property of San Miguel Power Association, Inc., and may be released to sponsors or other persons responsible for the administration of financial aid. By signing this application, I am aware that this scholarship will be presented at the time of graduation and announced at the Annual Meeting of San Miguel Power Association, Inc. By signing this application, I certify that the above information is true and honestly represents my goals to work in the energy industry. Date: Signature:

6 NOTE: These pages are for your information only. Please do not submit them with your application. Wes Perrin Memorial Scholarship Guidelines and Eligibility Requirements Page 1 of 3 PURPOSE: This scholarship is intended to give financial assistance to deserving students. It is to be applied toward tuition and fees. AWARD: A $2,500 per year scholarship is awarded annually for a maximum of four years. Subject to the discretion of San Miguel Power, the recipient may be deemed ineligible due to a recipient s inability to maintain status as a full-time student, demonstrate enrollment in an energy-related field, or provide the proper documentation to the cooperative. The award is intended to assist in obtaining a degree in the energy field at an undergraduate university or college or accredited trade college. The award is given without reference to race, creed, color, religion, or sex. ELIGIBILITY REQUIREMENTS TO APPLY: 1. Must be a graduating high school senior. 2. Must be a dependent of a San Miguel Power member and attend a public high school within the cooperative s service territory. 3. Must be pursuing post-high school education in an energy-related field of study. PROCEDURE: Application forms are available from the high school guidance offices, on the cooperative s website, or by request to (970) or (970) Checklist 1. Complete the application form. 2. Write a minimum 500-word essay demonstrating your passion for the energy field and your plan to achieve your goal to work in the industry. 3. Include an official high school transcript. 4. Include one letter of recommendation. Letters should be from someone who knows you personally and has witnessed, supported, mentored or helped you identify your desire to pursue an energy-related career. 5. The completed application with accompanying items must be received no later than February 26, 5, 2016 by the SMPA Scholarship Program Coordinator. 6. SMPA Scholarship Program Coordinator contact: San Miguel Power Attn. Alex Shelley PO Box 1150 Ridgway, CO or Updated October 2015

7 Page 2 of 3 Physical address San Miguel Power 720 North Railroad Street Ridgway, CO WHAT YOU SHOULD KNOW: 1. Recognition of the scholarship will be presented at your school s scholarship night or graduation ceremony. The scholarship will also be presented at the co-op s Annual Meeting of members in June. The recipient must formally accept the scholarship in writing no later than April 30 of the year awarded. Formal acceptance should be sent to: smpa.com or, PO Box 1150, Ridgway, CO Scholarship monies will be sent directly to the recipient and made jointly payable to the student and the university or college. This scholarship is paid on a per year basis. 3. Recipients are required to renew their assistance annually for the tenure of their studies, 3 renewals maximum for a total of 4 years of study. Renewals require: a. Proof of full-time enrollment in an energy-related field, which includes an official course schedule showing academic load. b. A completed application of renewal available at or by request c. Renewal information should be sent to: San Miguel Power PO Box 1150 Ridgway, CO no later than June 30 of each year. 4. If, for any reason, the recipient does not enroll in a qualified university, college, or trade school, drops out, does not carry a full academic load (based on a 12 hour minimum), the scholarship is forfeited. If, however, for any reason, the recipient is forced to withdraw from school on a temporary basis because of extenuating circumstances, the SMPA Board of Directors may consider honoring the scholarship at a later date. Otherwise the unused portion of the scholarship will be returned to the fund. ACCEPTABLE FIELDS OF STUDY: Applicants must be pursuing a degree in one of the following subjects in order to be eligible for the scholarship. Biotechnology Chemistry Electrical Lineworker Schools and Programs Engineering Chemical Civil Construction Energy Environmental Updated October 2015

8 Page 3 of 3 Mechanical Mining Nuclear Petroleum Physics Technology Hydroelectric Power Technology Solar Energy Technology Wind Energy Technology Other Applicants that have selected a field of study not listed above are responsible for fully demonstrating how their field of study is directly related to the energy industry and their intended career path. Failure to enter into one of the above areas of study and/or provide documentation of his or her studies to San Miguel Power will result in the scholarship being forfeited. Updated October 2015

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