Massachusetts AFL-CIO 66th Annual Scholarship Application

The scholarship exam will be given at high schools across Massachusetts between Monday, February 5, 2024 - Friday, February 9, 2024. Information regarding testing will be available at your guidance counselor's office. Please fill out information fully to register for this exam. Only students who are current high school seniors and graduating in 2024 are eligible to take this exam. The deadline to register is Friday, December 22, 2023. For questions email Carla Connolly, Scholarship Coordinator: cconnolly@massaflcio.org.

Student First Name

Student Last Name

Gender

Home Address

Home Address Line 2

City

State

Zip

Student Email

Please use personal email. All communication for this program will be through email.

Reenter Email Address

Cell phone

Please do not contact me by text message.

Please note: We communicate updates and reminders about the scholarship program via text message. If you do not wish to receive text messages, you may opt out by clicking below and you will receive the information in an alternate way.

Other phone

School

If your school is not listed, please enter your school in the space below.

Add

High School If Not Listed

School Counselor Name

School Counselor Email

Are you on an IEP or 504 Plan?

If you selected yes, please complete the next question.

What are your testing accommodations?

Parent 1 Full Name

Parent 2 Full Name

Union Member 1 Full Name

If a registrant is not a union member or related to a union member, leave questions related to union membership blank.

Relationship to student

Union Member 1 Home Address if different than student

Member 1 Union

Please select the Local Union your sponsor is a member of.

Add

Member 1 Local Union (if not listed)

If your sponsors Union is not listed in the previous dropdown, enter the information here.

Member's Status

Member's Telephone

Union's Telephone

Member 2 Full Name

Member 2 Relationship to student

Member 2 Home Address if different than student

Member 2 Union Name

Add

Member 2 Union if not listed

Member 2 Status

Member 2 Telephone

Member 2 Union Telephone

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