b'APPLICANT: Please complete all sections of this application:(Please type or print clearly) I.PERSONAL A. Name:FirstMiddleLastB. Home Address:StreetCityStateZip CodeHome Telephone: ____________________ Cell Phone: ____________________ Email: __________________C.MRCA Member Company, City, State: ___________________________________________________ Relationship to employee at member-company (circle one and provide name): MotherFatherAunt UncleOther (provide details) ________________________________________________________________________________D.Name and address of the educational institution you are currently attending or from which yourprovisional acceptance has been made: Name of SchoolStudent ID # StreetCityStateZip CodeIndicate the highest education level you have completed at time of application: High School SeniorFreshmanSophomoreJuniorSeniorGraduate SchoolC.What is your grade point average (GPA) at the time of application? (3, 4, 5, or 6 point scalecircle one)D.In what program do you expect to get your degree? E.List any extracurricular activities in which you have participated in high school and college: (1) Student activities(2) Community activities(3) Athletics (4) Other 2www.mrca.orgMidwest Roofer 13'