Evelyn K. Titus Memorial Scholarship Application

EVELYN K. TITUS MEMORIAL SCHOLARSHIP APPLICATION

Applicant must be a Senior in High School and must reside in Warren County in order to qualify for this scholarship. Applicant must be majoring in Agriculture or Family & Consumer Sciences. Deadline to submit a complete application is February 28, 2021. Applicants will also go through an interview process which will be scheduled at a later time.
Please read the guidelines/instructions for this scholarship which can be found on Warren-Henderson Farm Bureau's website at www.whfarmbureau.org under the Foundation tab. Click on " Evelyn K. Titus Scholarship Guidelines." *

Yes, I understand that a complete application, including the application and all accompanying materials, must be submitted on or before February 28, 2021 to be eligible for this Evelyn K. Titus Scholarship.
SECTION 1. GENERAL INFORMATION
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
County Where You Reside *
E-mail *
Home Phone Number *

Area Code Phone Number
Cell Phone Number *

Area Code Phone Number
Gender *
Father's Name *
Father's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Father's Cell Phone Number *

Area Code Phone Number
Father's Occupation *
Mother's Name *
Mother's Address (if different than father's) *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mother's Cell Phone Number *

Area Code Phone Number
Mother's Occupation *
Applicant's Marital Status *
(Single; Married; Divorced)
Name of Spouse
(If applicable)
Spouse's Occupation
(If applicable)
# of applicant's dependents and their ages
(If applicable)
SECTION 2. ACADEMIC INFORMATION
High School Attending: *
Date of Graduation: *
List Your Most Current GPA: *
Submit an official transcript with application
List Your Class Ranking: *
Rank/# of Students in Class
List Your Composite ACT Score: *
List Your SAT Score (if applicable):
List Any Academic Honors You Have Received: *
SECTION 3. ACTIVITIES
List all agricultural and/or family and consumer sciences activies you have participated in. *
Briefly summarize your experience(s) in agriculture and/or family and consumer sciences. *
List all clubs you have belonged to. Indicate offices held, positions of leaderships and the activities in which you participated. *
List all church, civic or community activities you have been involved with and your responsibilities. *
SECTION 4. FINANCIAL ANALYSIS

Since financial need is one factor in selecting the recipients of the Evelyn K. Titus Memorial Scholarship, the following information will be used by the trustees in their selection process. All information is strictly confidential and will not be shared with anyone not involved with the selection process.
Do you plan to work during the summer? *
If yes, where do you plan to work?
List approximate hours and income.
Do you plan to work during the school year? *
If yes, where do you plan to work
List approximate hours and income.
Please indicate if you are receiving any sort of tuition waiver. *
Please list any other scholarships or other type of financial aid you are receiving and their value. *
Approximately what percentage of your education expenses are going to be paid for by your parents? *
Approximately what percentage of your education expenses will be in the form of student loans. *
Approximate amount of money you have saved for college. *
List any other sources of income that you have available to you. *
List the number of your brothers and/or sisters that are currently attending college. *
SECTION 5. PROFESSIONAL GOALS

Please tell us about your professional goals and objectives. Include contributions you expect to make to agriculture and/or family & consumer sciences and how this scholarship will help you to achieve these goals.
Please tell us about your professional goals and objectives and how your education will help to achieve those. *

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SECTION 6. REFERENCES

Please have two adult persons who know you fill out a reference form. They can access the Reference forms by logging onto the Warren-Henderson Farm Bureau's website, www.whfarmbureau.org. They need to look for reference forms for the Eveylyn K. Titus Scholarship (underneath the Foundation tab). At least one must be a current or past teacher. References may not be relatives of the applicant. The completed reference forms must be submitted to the Warren-Henderson Farm Bureau by the person filling out the form. They can fill them out and submit them online or print them and send them to the Farm Bureau at PO Box 348, Monmouth, IL 61462 or bring them to our office at 1000 N Main St.
Name of Reference #1 *

First Name Last Name
Phone number of Reference #1 *

Area Code Phone Number
Name of Reference #2 *

First Name Last Name
Phone Number of Reference #2 *

Area Code Phone Number
SECTION 7. APPLICANT'S E-SIGNATURE
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature: *
Date *
Checklist *
Should be Empty:

EVELYN K. TITUS MEMORIAL SCHOLARSHIP APPLICATION

SECTION 1. GENERAL INFORMATION

SECTION 2. ACADEMIC INFORMATION

SECTION 3. ACTIVITIES

SECTION 4. FINANCIAL ANALYSIS

SECTION 5. PROFESSIONAL GOALS

SECTION 6. REFERENCES

SECTION 7. APPLICANT'S E-SIGNATURE