Molo Petroleum LLC Scholarship Application

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Molo Petroleum LLC Scholarship Application Molo Petroleum LLC Scholarship Applicant: Thank you for your interest in pursuing a Molo Petroleum LLC Scholarship. Please review the qualifications on the following page. If you meet the requirements, please submit an application as directed by February 1 st. If you have any questions regarding the process, time-line, or other aspects of the scholarship program, please contact: scholarships@molocompanies.com or call 563-557-7547. You will be contacted on or around March 1 st by letter or phone call communicating to you if you are or are not being awarded a scholarship. Please read the Scholarship Guidelines and application carefully. Select, and complete the appropriate application, based on your academic level. You will need to attach ALL of the following documents to make your scholarship application complete. Failure to do so will result in you not being considered for a scholarship. Personal Statement: Your Personal Statement addresses your future goals in relation to your academics. Why are you pursuing an education? What do you plan to do with your education? Student Activity Summary: The Scholarship Committee is interested in your school, civic and extracurricular activities, accomplishments and participation. Please attach a summary of your activities noting any offices held or honors received. Transcripts: An UNOFFICIAL copy of your transcripts should be included. This completed Application Form. Incomplete application forms or applications received after the due date will invalidate your application and you will not be considered for a scholarship.

Criteria for eligibility: Applicant or applicant's parent(s) must have been employed at a Molo Petroleum location for one year prior to application date. Applicant must be classified a full-time student as a freshman, sophomore or junior in an accredited four-year institution during time of application process or, a first or second year student in a Community College or Trade School. Applicant must be classified a full-time student at the time funds are disbursed. Emailed submission to scholarships@molocompanies.com is the preferred method of submission, but if you wish you can also send via U.S. mail (postmark used for deadline date) to the following address: Molo Petroleum Scholarship Program Attn: Scholarship P.O. Box 1540 Dubuque, IA 52004-1540

Application Status when applying: H igh School Senior College Freshman College Sophomore College Junior/5th Year Senior PERSONAL PROFILE Please Type E-mail Address Mailing Address Home Phone # ** IF YOU, YOUR SPOUSE, OR ONE OF YOUR PARENTS ARE WORKING AT MOLO PETROLEUM LLC, COMPLETE THE FOLLOWING. Name Work Location Date Employed Position

Application Molo Petroleum LLC profile If you are currently working at Molo Petroleum LLC, complete the following: Co. Location Store Address Date Employed Position Other Locations School Name School / College / University Attending Information COLLEGE PROFILE - this is the college/university any award will be used for. School Address School Phone # Last Semester GPA Accumulative GPA Current Year (i.e. Junior 1 st Semester) Note: Please include a current transcript with your submission (does not need to be an official form)

Personal Statement Please express your thoughts outlining your future goals and discuss why you feel you should be considered for a Molo Petroleum LLC Scholarship. Please include what school you will be attending and what field of study you have chosen. Note: Your personal statement must be typed in order to be considered for a Molo Petroleum LLC Scholarship. Please attach a separate sheet. Student Activity Summary The Molo Petroleum LLC Scholarship Committee is interested in your school, civic, and extracurricular accomplishments and involvements, as well as your academic standing. Please list your activities, including years of participation, offices held, and honors received. Areas to consider: *Student Organizations - (Student council, Y-Teens, class office, clubs, yearbook, newspaper, etc.) *Athletics - (Various sports teams, honors, etc.) *Art, Music, Speech/Drama - (Vocal, instrumental, debate teams, theater productions, etc.) *Community Involvement, Philanthropy - (church, Boys/Girls State, 4-H, FFA, choirs, youth work) *Other - (National Honor Society, scholarships, activities, awards, etc.) Note: Your student activity summary must be typed in order to be considered for a Molo Petroleum LLC Scholarship. Please attach a separate sheet. Signature Date