2023 Clay County Farm Bureau Scholarship

2023 CLAY COUNTY FARM BUREAU FOUNDATION SCHOLARSHIP

The information provided on this form will be used by the Clay County Farm Bureau Foundation Committee to select recipients for scholarships. It is important that you give complete details concerning your college/career plans, activities and additional information.
I. BASIC INFORMATION
Date

MonthDayYear
Date
Student's Full / Legal Name*

First NameLast Name
Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Phone Number*

Area CodePhone Number
Student E-mail*
What is the name of your local newspaper?
Parent/Guardian Name (1)

First NameLast Name
Parent/Guardian Address (1)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name (2)

First NameLast Name
Parent/Guardian Address (2)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Occupation (1)
Parent/Guardian Occupation (2)
Are your parents/Guardians Clay County Farm Bureau Members?

YesNo
If yes, please list Farm Bureau member number
II. ACADEMICS
Expected Graduation Date

MonthDayYear
Date
Cumulative GPA
High School Attending
High School Rank
your rank/total # students
College/University Currently Accepted or Admitted to
Is your major area of study related to agriculture?

YesNo
If so, how?
Composite ACT score
Please list any high school honors you have received
III. QUESTIONS
Please list any academic, agricultural, church or community activities you have been involved in. Indicate offices held, position of leadership, and special committee involvement you may have participated in.
Briefly summarize your experiences within the agricultural field.

IV. FINANCIAL INFORMATION
How will this scholarship benefit your educational financial needs? (Be specific.)
Will you work to support your education?

YesNo
If so, where and how many hours will you work in a week?
Location/# hours per week
Have you received any scholarships or financial waivers for the upcoming scholastic year?

YesNo
If so, please indicate them.

V. LETTER OF RECOMMENDATION
Please attach at least one letter of recommendation with your application. This recommendation may come from a teacher, coach, supervisor, advisor, etc., but may not come from a family member. No more than two letters of recommendation will be considered for each applicant.

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VI. ESSAY
Please attach a double-spaced, typed essay explaining your educational goals and objectives. State how this scholarship will help you contribute to your goals and how you will improve the agricultural industry. Please do not exceed one page or 400 words.

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Student Signature

Clear
Date

MonthDayYear
Date
Parent/Guardian Signature

Clear
Date

MonthDayYear
Date

Should be Empty:

2023 CLAY COUNTY FARM BUREAU FOUNDATION SCHOLARSHIP

I. BASIC INFORMATION

II. ACADEMICS

III. QUESTIONS

IV. FINANCIAL INFORMATION

V. LETTER OF RECOMMENDATION

VI. ESSAY