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Please provide a list of three, non-family members who could tell us about your abilities, skills, adn level of commitment. Please include their name, their relationship to you, and their phone number.

Disclaimer & Signature
By signing below, I authorize LANG DIESEL INC. to investigate all statements contained in this scholarship application as they may deem necessary in arriving at a decision.

Please only hit the Apply button once. A confirmation page will appear once your application has been submitted successfully.