Name *

First

Last

Program Opportunities (Select at least one, or more than one if interested)

Junior MAC Member (actively recruiting)

Youth Tour (application period for 2025 is now closed)

Cooperative Leadership Camp (application period for 2025 is now closed)

Street Address *

City *

State *

Zip Code *

Phone (Mobile)

Phone (Home)

Email *

Date of Birth *

Parent or Guardian Name *

First

Last

Phone *

Email *

High School *

Principal Name *

First

Last

Principal Email Address *

Grade *

Academic Honors *

How did you hear about this program? *

Student Resume *

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Essay Topic: EnergyUnited is dedicated to building a brighter energy future for its members by supporting beneficial electrification initiatives and by continuing to increase its utilization of renewable energy resources. When you think of a brighter energy future for your community, what do you envision? How can electric cooperatives like EnergyUnited support your vision? *

School Transcript or Letter from School Counselor Confirming Transcript Request *

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