National Award Programs Cash Claim Form

National FFA Award Programs Cash Claim Form
Congratulations on your award. Please complete this form to claim your cash award. This form must be completed and submitted by December 1. All cash awards will be disbursed after December 1. All cash awards not claimed by December 1 will be forfeited.
Full Name as it appears on award application/or the event certification
Full Legal Name as it should appear on award check or IRS forms (Must be provided for all submissions)
FFA Member ID
9 digit number found on FFA profile/roster Ex: 600999999
Email*
example@example.com
Social Security Number*
Chapter ID Number*
Chapter ID should include state abbreviation and 4 numbers (ex: IN1234)
Chapter Name*
Address*
Select the programs in which you are claiming cash awards.*

Agriscience FairAmerican Star AwardsAgricultural Proficiency AwardsCareer and Leadership Development Events
Agriscience Fair Divisions
American Star Award Areas
Agricultural Proficiency Award Areas
Career and Leadership Development Events
Select how you would prefer to receive your cash award. *If ACH information is not verified, funds will be distributed by check.*

Mail CheckACH direct deposited to my bank account
Routing Number*
must be 9 numbers - no spaces
Account Number*
must be 9-13 numbers - no spaces
Bank Name*
I hereby certify that all information submitted in this form is true, accurate and complete. I also acknowledge that if funds are unable to be electronically transferred a check will be issued and mailed to the address given within this form. Funds will not be distributed if information provided is incomplete. I acknowledge that funds will be distributed after December 1. *
Should be Empty:

National FFA Award Programs Cash Claim Form