Illinois 4-H Scholarship Application- 2022

Illinois 4-H Scholarship Application
General Rules and Regulations for 4-H Scholarships
- Scholarships are open to Illinois 4-H members age 15-19 as of 9/1/2022.
- To apply you must have been enrolled in the 2021-2022 4-H year.
- Applicants can only win one scholarship per program year.
- Applicants can only win once in each of the different award areas.
- Scholarship applications are due November 1.
- Two recommendations must be sent in.
  - It is the responsibility of the applicant to send the link and ensure they have completed it.
  - Recommendations will be due November 7.
  - Link to send to references:https://form.jotform.com/211994409315156.
- The announcement of winner will be sent to County Extension staff and to the e-mail listed on your application.
- Winners will be invited to the Illinois 4-H Celebrating Excellence Awards Banquet on April 8 to receive the award.
- This scholarship is sponsored by the Illinois 4-H Foundation. If you receive this award we will provide you contact information to send thanks to a list of donors.
Contact Information
Name*

First Name Last Name
Email*
Phone Number*

Area Code Phone Number
Date of Birth*

MonthDay Year
Date
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Gender Identity*
Race *
Ethnicity *
Parent/Guardian Name(s):*
County *
Club Name*
Years of 4-H Membership*
Upload Photo*

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Attach a high quality digital JPEG head & shoulder photo Cancelof

Educational Information

Scoring up to 10 points
Name of High School *
Graduation Month & Year*
Is your GPA on a 4.0 or 5.0 scale?*
Current GPA (actual unweighted)*
Upload a signed copy of your transcript to verify GPA*

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Name of University or Post-Secondary Institution (if currently enrolled)
Academic Major (or anticipated major)*

School and Community Involvement

Scoring up to 20 points

List up to 8 different non- 4-H related activities or organizations you participated in through school, community, or industry involvement. Please provide clarity by spelling out unfamiliar abbreviations. Note any specific leadership roles or responsibilities you held, list any related awards or recognition you received, and which years you participated (i.e. 2015-2018 or 2016-Present). The selection committee will be able to review your entire response in each field even though you may only see a partial response in a box. *

	Activity or Organization	Leadership Roles	Awards or Recognition	Years Participated
1
2
3
4
5
6
7
8

List up to 3 work experiences you have had (i.e., farm labor, part-time or summer job/ internship).*

	Job Title	Responsibilities	Employer	Employment Dates
1
2
3

Video and Essays

Scoring up to 45 points
Upload a video of you "Telling your 4-H Story"

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Length of video 3-5 minutes. Cancelof
If you are having issues loading the "Telling your 4-H Story" video above you may upload to an online platform (YouTube, Box, Google) and paste the URL link in the box below. Please make sure sharing settings are enabled.
How has 4-H impacted your life?*

0/250
Future Plans and Career Goals*

0/250
Project Specific Essay

- Essays will generate on the next pages based off the categories you are applying for. Scoring up to 25 points on project specific essay.
Scholarship Applying For:*

Animal ScienceCivic Engagement/Global LivingCreative Performing Arts & CommunicationHealthy Living/NutritionLeadershipNatural Resources & Environmental SciencePersonal GrowthSTEM/Robotics

Animal Science
How has your animal science projects advanced your science, communication and leadership skills?

0/500
Civic Engagement/Global Living
What is the importance of civic engagement and service learning?

0/500
Leadership
How have you demonstrated the six areas of the 4-H Leadership Model (planning, promoting, teaching, mentoring, advocating and advising).

0/500
Natural Resources & Environmental Science
What environmental issues do you feel should receive the highest priority of our society over the next 25-30 years and why?

0/500
STEM/Robotics
In your opinion, what current technology or STEM application is most important to our future? Why, and what are the future implications of said technology on the human race?
Food Systems
Based on data from the USDA available from the most recent Census, the average age of farmers in Illinois is 58. Additionally, only 1.3% of farmers in Illinois identify as Black, Indigenous, Asian/Pacific Islander or Latino. This means that in Illinois, there is a need for young farmers, particularly those from diverse racial or ethnic backgrounds, to be supported in having access to land and other important resources required to run a successful farm operation. What steps can be taken in the agriculture sector so that under-represented farmers have an equal opportunity to be successful?

0/500
Creative & Performance Arts/ Communication
How do you express yourself through your project area?

0/500
Healthy Living/ Nutrition
How have you tackled a healthy living and or nutrition community issue? For example childhood obesity, screen time or building resiliency in self or other youth. What problems were you addressing or trying to solve? How did you identify or recognize the issue? What action items did you take as a result and why does it matter?

0/500
Personal Growth
A key to taking advantage of great opportunities is being prepared for them when they arrive. In your essay, please describe what personal characteristics you have worked to develop or improve in order to be ready for life as a young adult and how have you worked to develop or improve them. How has 4-H helped to develop you as a person.

0/500

Recommendations

Complete the information below on the two individuals who will be writing your recommendations. Recommendation #1- 4-H Volunteer or University of Illinois Extension Staff Member (non-related), Recommendation #2-Individual from Applicant's Community (non-related). Please contact your references and give them the following link to complete the recommendation: https://form.jotform.com/201048974048155.
Recommendation #1- 4-H Volunteer or University of Illinois Extension Staff Member (non-relative), Scoring up to 5 points.
Name*

First Name Last Name
Title*
(Club leader, extension staff, volunteer)
Phone Number*

Area Code Phone Number
Email*
example@example.com
Recommendation #2- Individual from Applicant's Community (non-relative). Scoring up to 5 points.
Name*

First Name Last Name
Association to Applicant*
Phone Number*

Area Code Phone Number
Email*
example@example.com

I CERTIFY THAT ALL STATEMENTS OR INFORMATION I HAVE PROVIDED ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. ANY DELIBERATE MISREPRESENTATION FOUND IN THIS APPLICATION MAY BE CAUSE FOR DISQUALIFICATION OF THIS APPLICATION AND MAY PROHIBIT ME FROM APPLYING AGAIN IN THE FUTURE.
Applicant's Signature*

Clear
Name of Applicant*

First Name Last Name
Date Signed by Applicant*

MonthDay Year
Date
Should be Empty:

Illinois 4-H Scholarship Application

Contact Information

Educational Information

School and Community Involvement

4-H Involvement

Video and Essays

Project Specific Essay

Animal Science

Civic Engagement/Global Living

Leadership

Natural Resources & Environmental Science

STEM/Robotics

Food Systems

Creative & Performance Arts/ Communication

Healthy Living/ Nutrition

Personal Growth

Recommendations