Edwards County Farm Bureau

Young Leaders Committee

$500 Collegiate Scholarship

PLEASE TYPE
SECTION 1 GENE !L INFO "!TION
Name Home Address
Street City State Zip

Date

Home Phone (

) Date o grad!ation

High School attended Comm!nity College attended (i applica"le) Comm!nity College #a$or %o!r & year !ni'ersity applied or (i applica"le) %o!r & year !ni'ersity #a$or Date o grad!ation( CC Parents*+,!ardian*s Name Parents*+,!ardian*s Address
Street

#inor

#inor %o!r ) year

City

State

Zip

SECTION # !C!$E"IC INFO "!TION

-hat is yo!r High School c!m!lati'e ,.P.A./ -hat is yo!r high school ran6/ (i applica"le) -hat is yo!r collegiate c!m!lati'e ,.P.A./ -hat is yo!r composite ACT score/ SAT score/ o!t o (0.1 2 A3 4.1 2 53 etc.) (0.1 2 A3 4.1 2 53 etc.)

SECTION % !CTI&ITIES
Please detail yo!r ans7ers to the 8!estions to the "est o yo!r a"ility. Yo! may add additional pages i necessary. List any academic honors or a7ards yo! ha'e recei'ed.

List any agric!lt!ral organi9ations o 7hich yo! 7ere or are a mem"er o . :ndicate o ices held3 and any other positions o leadership in 7hich yo! participated.

List any ch!rch3 ci'ic3 or comm!nity acti'ities o 7hich yo! participated in.

5rie ly s!mmari9e any e;periences yo! ha'e had in agric!lt!re or 7ith an agri"!siness.

SECTION ' ( OFESSION!L GO!LS

Please e;plain yo!r pro essional goals and o"$ecti'es and ho7 this scholarship 7ill help yo! achie'e those goals. (Limit < page)

SECTION ) !G IC*LT* !L I"(!CT

Please e;plain ho7 agric!lt!re and+or 0)H+%%A has impacted yo!r li e. (Limit < page.)

SECTION + FIN!NCI!L !N!LYSIS

Since inancial need is not a actor in selecting recipients3 the ollo7ing in ormation 7ill only "e !sed to aid the committee in the deli"eration i they eel it is necessary. The in ormation yo! pro'ide 7ill "e 6ept strictly con idential. Do yo! or 7ill yo! 7or6 d!ring the school year to s!pport yo!r ed!cation/ : so3 7hat type o 7or6/ -ill yo! 7or6 d!ring the school "rea6s and in the s!mmer months/ : so3 7hat type o 7or63 and 7here/ Ha'e yo! recei'ed any other type o inancial aid or the !pcoming school year/ ================ : so3 7hat type and ho7 m!ch/ ========================================================= ===================================================================================== :n the space "elo73 incl!de any other in ormation yo! eel is rele'ant to yo!r inancial need.

SECTION , (E SON!L EFE ENCES

Please ha'e t7o character re erence letters s!"mitted along 7ith this application. >e erence letters can "e rom past pro essors3 cl!" sponsors3 coaches3 etc. >e erences rom amily mem"ers are not applica"le. Letter sho!ld detail ho7 the indi'id!al 6no7s the applicant3 7hat their position or title is3 and a phone n!m"er 7here they can "e reached i more in ormation is needed.

SECTION - COLLEGI!TE./IG/ SC/OOL T !NSC I(TS

:ncl!de a copy o yo!r collegiate transcript (i applica"le) and yo!r high school transcript.

I hereby certify, that to the best of my knowledge the information provided in this application is correct and complete and I hereby release the information provided in this application to the Edwards County Farm Bureau for their use in determining the winner of this scholarship. I also understand, that the Edwards County Farm Bureau will retain this application indefinitely, and will deem the information contained in this document as confidential to all people, e cept those authori!ed to evaluate this application for scholarship purposes including, but not limited to the Edwards County Farm Bureau Board of "irectors, Edwards County Farm Bureau #oung $eader%s Committee, and the Edwards County Farm Bureau &anager.

'pplicant%s signature

"ate

(arent)*uardian%s signature (: !nder age <?)

"ate

Send application to( Ed7ards Co!nty %arm 5!rea!@ Yo!ng Leader*s Committee <A S. %i th St. Al"ion3 :L BC?1B

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