Ocean Mist Farms Scholarship Application Form

Date*

MonthDayYear
Date
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
High School Name*
Expected Graduation Date*

MonthDayYear
Date
Cumulative GPA*
Name of School Planning to Attend*
Field of Study
Enrollment Date

MonthDayYear
Date
How did you hear about the Ocean Mist Farms Scholarship Program?

Family MemberFriendSchoolOther
If Other, please provide information:
Do you have a parent or guardian who currently works at Ocean Mist Farms or its affliate?

YesNo
If so, please provide their full name and job title:
Are you interested in learning more about our Summer Internship Program?*

YesNo

List your Community Service activities and Volunteer Work

Rows	Name of Organization	Position/Role	# of Hours
1
2
3
4
5

List any Club Membership you have participated in:

Rows	Name of Club	Position/Role	Date(s)
1
2
3
4
5

List your extracurricular activities, including sports, hobbies and organizations:

Rows	Name	Position/Role	Date(s)
1
2
3
4
5

List Employment Experience:

Rows	Name of Employer	Position/Role	Date(s)
1
2
3
4
5

Additional Community Service, Volunteer, Club, Activities, Employment Experience:

Cancelof
Official School Transcripts*

To be used as proof for cumulative GPA. *Must be PDF format
Cancelof
Essay*

Essay to describe a situation in which you have shown leadership by applying one or more of the Ocean Mist Farms Guiding Values of Quality, Respect, Innovation, Shared Success, and Ingegrity & Accountability. (to be approx. 500-700 words) *Must be Word or PDF format
Cancelof
Letter of Recommendation #1*

Letter of Recommendation (one from school teacher and another from coach, employer, etc). *Must be Word or PDF format
Cancelof
Letter of Recommendation #2*

Letter of Recommendation (one from school teacher and another from coach, employer, etc) *Must be Word or PDF format
Cancelof
Proof of Higher Education Acceptance & Enrollment*

ie. Acceptance Letter, Proof of Registration, etc. *Only vocational schools that are accredited by an organization that is included in the US Dept. or Education’s list of nationally recognized accrediting agencies will be considered credible for this purpose. *Must be Word or PDF format
Cancelof
Parent/Guardian Name*

First NameLast Name
Parent/ Guardian Signature*

Powered by Jotform SignClear
Applicant's Declaration

I hereby declare that the information provided in this application is true and accurate to the best of my knowledge. I understand that any false information may result in the disqualification of my application.
Applicant's Signature*

Powered by Jotform SignClear
Date signed*

MonthDayYear
Date
Please verify that you are human*
For questions regarding this application, please email:

scholarships@oceanmist.com
Should be Empty: