Road to Success Scholarship Application Form

Scholarship Application

The Sangamon County Farm Bureau Foundation is offering five $1,000 scholarships to help offset the cost training family and employees of farmers in Sangamon County to become a commercial truck driver to transport farm commodities and inputs.
Eligibility

1. Applicant must be a current farmer member (MM member classification) of the Sangamon County Farm Bureau.

2. Family or employee (hereafter known as the student) of the applicant must be an Illinois resident.

3. Student must be enrolled or planning to enroll in a commercial driver training program at an Illinois Community College.

4. Sangamon County Farm Bureau Directors and employees of the Sangamon County Farm Bureau, or their immediate family members, are not eligible to apply.
Terms

Applicants receiving the scholarship must provide proof of enrollment of their student in a driver training program during the calendar year of their application. Failure to provide proof of enrollment will constitute the forfeiture of the scholarship. Payments will be made directly to the Illinois Community College where the student is enrolled.
Farm Bureau Member's Name *

First Name Last Name
Member ID: *
Permanent Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Member Phone Number *

Area Code Phone Number
Member E-mail *
Student Section
Student Birth Date

Month Day Year
Last 4 SS #
Are you a United States Citizen?

Yes No
Are you a resident of Illinois?

Yes No
Illinois Community College Attending/Planning to Attend

Name of College

Street Address Line 2

City State / Province
Name of Driver Training Program
Date your Training Program Begins/Began

Month Day Year
Date

Scholarship Application

Terms

Student Section

Thank You!