Technician Scholarships Automotive * Diesel

Auto Collision * Motorcycleand

Tool Awards

APPLICATION FORMDeadline: January 15, 2016

Program Partners:

150 East Gilman Street, Suite AMadison, WI 53703

(608) 251-4631

Fax: (608) 251-4379e-mail: jlolson@watda.orgWebsite: www.watda.org

Kenneth & Janet Pike Family Fund

SCHOLARSHIP INFORMATIONThe Foundation of the Wisconsin Automobile and Truck Dealers welcomes your application for an Automotive, Diesel, Auto Collision or motorcycle Technician Scholarship.

SCHOLARSHIP AWARDSScholarship amounts vary and may be valued up to full tuition. Scholarships are based on funding availability.

Scholarships are paid each semester depending on the specific program. For example a $3,000 scholarship will be paid over 4 semesters (fall & spring) at $750 per semester. A semester grade point average of 2.8 must be maintained to be eligible for payment.

Tool awards valued over $3,500 are provided by Snap-on Corporation, Kenosha, WI. Auto Collision Technician Scholarships funded by Wisconsin Auto Collision Technicians

Association, Ltd. (WACTAL) are available to graduating high school students planning to attend a Wisconsin technical college that is a member of WACTAL.

ELIGIBILITYAll applicants for any of the above scholarships must:

Be a Wisconsin resident. Have a valid driver’s license with a good driving record. Be a high school graduate or high school senior graduating in 2016. Plan to attend or currently be enrolled (with an anticipated graduation date no earlier

than the spring of 2017) in an automotive, auto collision or diesel technician program at a NATEF-certified Wisconsin technical college.

Plan to pursue a professional career in the automotive, diesel or auto collision industry.

Successfully complete a series of assessment evaluations at one of the testing sites listed on the Scholarship Assessment Form. Testing must be completed by January 15, 2016.

Current technical college students do not need to complete the assessment tests, but they will need to send in their transcripts from their first semester as soon as it is available.

SELECTION Applicants will be evaluated on the basis of information provided in the application,

high school transcripts, letter of recommendation, and assessment evaluations. All applicants selected as finalists will be invited to a personal interview with

representatives from The Foundation, local technical college and local dealership. When possible, students are placed in sponsoring dealerships with part time

employment to provide on the job training and mentoring. Scholarships are awarded from May through October, based on funding availability.

SCHOLARSHIP APPLICATION FORM

Name: Home Phone:

Permanent Address: Cell Phone:

City, State, Zip: County:

Current Address:

Age: Date of Birth: e-mail:

High School: HS Phone:

Guidance Counselor: Graduation Date:

Name of Parent or Guardian:

1. Name of NATEF-Certified Wisconsin Technical College you are planning to attend:

a. Please check the box below for the program in which you intend to enroll:

Automotive Diesel Auto Collision 2 Yr. Associate Degree Ford ASSET GM ASEP

Mopar CAP Honda PACT 2 Yr. Technical Diploma 1 Yr. Technical Diploma Technical Certificate Express Tech-Plus Motorcycle

2 Yr. Associate Degree

2 Yr. Technical Diploma

1 Yr. Technical Diploma

2 Yr. Associate Degree

2 Yr. Technical Diploma

1 Yr. Technical Diploma

b. If you are already attending technical college, how many semesters do you have left?

c. Anticipated date of graduation from technical college:

2. List automotive related activities in which you have participated (such as Auto Tech/Auto Collision Youth Apprenticeship, Automotive Youth Educational Systems (AYES), Skills_USA, Technical College Skills Competitions, trouble shooting contests, etc.):

3. List other activities in which you have participated (sports, music, community, volunteer, charitable, etc.):

4. List committees served, offices held, or other leadership positions you have had:

5. List honors and awards received (such as National Honor Society, Scouts, etc.):

6. What do you feel are your academic strengths and weaknesses?

7. Discuss some of your long-term goals in the auto/truck retail industry:

8. Are you currently working in the automotive/truck industry? Yes No

If yes, where?

Service Manager:______________________________________ Phone:

9. Do you have a valid driver’s license with a good record? Yes No

Required Signature:

To the best of my knowledge, I have provided WATDA full information concerning all questions on the application. I agree to report to WATDA all factors and documentation, including assessment evaluations, transcripts and attendance information, which could affect consideration of my application. I understand that failure to provide true and complete information could mean forfeiture of scholarship funding and tools.

Applicant Signature________________________________________ Date

Name (please print)

COMPLETE APPLICATIONS INCLUDE: The completed application form. One letter of recommendation from a person such as former teacher or high school counselor, local auto or truck

dealer, minister or priest, employer or neighbor. The completed evaluation form, preferably completed by your automotive instructor or employer. Your high school transcript. If your school does not use a 4.0 scale, please have your GPA converted to a 4.0

scale before submitting it. You may send additional transcripts as they become available and they will be added to your file.

Assessment testing. Make an appointment with your local technical college (see “Test Site Information”) to take the six assessment tests required to be considered for a scholarship. Test results are received electronically. You should not wait until you take the tests to send in your application form. Current technical college students are exempt from this requirement.

Application Process must be completed by January 15, 2016. All documents should be mailed to:

The Foundation WATDA150 East Gilman Street, Suite AMadison, WI 53703

Incomplete applications will not be considered. Be sure to keep copies for your records.

Questions concerning this process can be directed to Julie Olson, Program Director at 608-251-4631 or e-mailed to jlolson@watda.org.

Scholarship AssessmentTest Site Information

Select a testing site below and call to schedule an appointment to take the required tests.Specify that you are testing for the WATDA Scholarship.

LOCATION CONTACT DATE/TIME Blackhawk Technical College Contact: _______Terese Tann

By Appointment6004 S. County Trunk G Phone: 608-757-7666

Janesville, WI 53546-9458 Room: 2200 – Student Success Center

Chippewa Valley Technical College Contact: _____Jami Rubenzer9:00 a.m. - By Appointment:

620 West Clairemont Avenue Phone: 715-833-6346 Saturday’s - call site for datesEau Claire, WI 54701-6162 Room: 114 ECB (subject to change) By Appointment only after 12/15

Fox Valley Technical College Contact: ______Tiffany SchuhFriday, January 22, 2016

1825 North Bluemound Drive Phone: 920-993-5139 Testing starts promptly at 1:00 p.m. Appleton, WI 54913 Room: E-107 (App. Campus) Entrance #11 Photo ID & preregistration required

Gateway Technical College Contact: ________Kelly MorinBy Appointment

3520 30th Avenue Phone: 262-564-2566Kenosha, WI 53144 Room: Assessment Center

Gateway Racine Campus Contact: __________Kurt LoisBy Appointment

1001 S. Main Street Phone: 262-619-6474Racine, WI 53403 Room: L113 – Lake Building

MATC - Madison Assessment Center Contact: ________Mary WahlBy Appointment

2125 Commercial Avenue Phone: 608-246-5220, option 8 Monday & Wednesday morningsMadison, WI 53704-2599 Room: A215

MATC - Milwaukee Mequon Campus Contact: _Cecilia Higa-LehmanBy Appointment

5555 W. Highland Road Phone: 262-238-2204 Mequon, WI 53092-1199 Room: A-110 D

Mid-State Technical College Contact: _______Gina KlukasBy Appointment

500 32nd Street North Phone: 715-422-5455Wisconsin Rapids, WI 54494 Room: T113 – Testing Center

Moraine Park Technical College Contact: ______Angie GerlachBy Appointment

235 North National Avenue Phone: 920-924-3449Fond du Lac, WI 54935 Location: MPTC Fond du Lac

Campus

Nicolet Area Technical College Contact: __Lori Vance or Tom Raykovich By Appointment

Box 518 Phone: 715-365-4448Rhinelander, WI 54501-0518 Room: 201, UW Transfer Center, 2nd building on left, 2nd floor

Northcentral Technical College Contact: ________Julie KrykaBy Appointment

312 Forrest Avenue Phone: 715-623-7601 ext. 7702 Antigo, WI 54409 Room:

Northeast Wisconsin Technical College Contact: ____Michelle PhillipsBy Appointment

2740 West Mason Street Phone: 920-498-5427 or 920-498-6316 Green Bay, WI 54307-9042 Room: SC 365 - Assessment

Center

Southwest Wisconsin Technical College Contact: _Mary Jo Sherman or Danielle Seippel By Appointment

1800 Bronson Blvd. Phone: 608-822-2313 or 608-822-2317Fennimore, WI 53809 Room: Testing Center – Building 200, Room 231

Waukesha County Technical College Contact: ____Patrice ReighterBy Appointment

800 Main Street Phone: 262-695-6215Pewaukee, WI 53072-4698 Room: College Center Building, Room C022

Wisconsin Indianhead Technical College Contact: ______Emilie BailkeyBy Appointment

1900 College Drive Phone: 800-243-9482Rice Lake, WI 54868 715-234-7082, ext. 5233

Western Technical College Contact: ____Kristina LemmerBy Appointment

400 7th Street North Phone: 608-785-9566La Crosse, WI 54602-0908

If you are unable to make an appointment to take the assessment tests at your local technical college listed above, you may be able to take the tests at your high school. Have your guidance counselor call Julie Olson at 608-251-4631 to make arrangements.

Be sure to review the “sample student questions” on our website: www.watda.org before you take the tests!

TEST RELEASE FORMStudents must schedule an appointment to take all required tests at the technical college they plan to attend. Please let the test site contact person know you are calling to schedule an appointment for the Wisconsin Automobile & Truck Dealers Foundation Technician Scholarship Assessments. There may be an assessment fee charged by the technical college site.

Required tests include:

Bennett Mechanical Reasoning Assessment (Form S)

DAT for PCA (Differential Aptitude Test – Space Relations)

ACCUPLACER Tests:

Arithmetic Elementary Algebra Reading Comprehension Sentence Skills

Whereas, I have submitted my application as a student to participate in The Foundation of the Wisconsin Automobile & Truck Dealers Technician Scholarship, I hereby authorize and grant permission to the college testing site and The Foundation of the Wisconsin Automobile & Truck Dealers Scholarship Committee, or either one, to release to each other, any information relating to the ACCUPLACER, Differential Aptitude and Mechanical Reasoning assessments.

Name of Applicant (please print):

Applicant Signature:__________________________________________________ Date:

If applicant is under 18 years old:

Name of Legal Guardian (please print):

Guardian Signature:__________________________________________________ Date:

Julie Olson, Program DirectorThe Foundation of WATDA

150 East Gilman Street, Suite A

Madison, WI 53703

608-251-4631jlolson@watda.org

ScholarshipEVALUATION FORM

To be completed by automotive instructor or advisor. May be completed by another teacher or employer if student does not currently have an automotive instructor.

Name of scholarship applicant:

Please rate this applicant with respect to the following:

Low Average High Comments

Intellectual Ability 1 2 3 4 5

Responsibility, Dependability 1 2 3 4 5

Academic/Professional Growth Potential 1 2 3 4 5

Leadership 1 2 3 4 5

Ability to Work with Others 1 2 3 4 5

Motivation/Initiative 1 2 3 4 5

Communication Skills 1 2 3 4 5

What are the applicant’s strongest characteristics and abilities?

What factors do you think we should particularly consider in our evaluation of this applicant?

Additional comments necessary for evaluation of this applicant:

Length of time you have known applicant: In what capacity?

Name: Title:

Department or Organization: Phone:

Address: e-mail:

Signature: Date:

Thank you! Please return this form to:

Julie Olson, Program Director The Foundation of WATDA150 East Gilman Street, Suite AMadison, WI 53703e-mail: jlolson@watda.orgfax: 608-251-4379