Xperience Ag, Inc. College Scholarship Application Form 2026

Xperience Ag, Inc. College Scholarship Application Form 2026

Scholarship applications for 2026 will be accepted until March 1, 2026. Applicants must be planning to pursue a degree within an agricultural field of study and currently reside in the state of Indiana. This nonrenewable scholarship will be awarded to one recipient in the amount of $1,500.00 which will be paid after enrollment is verified.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Educational Information

List in chronological order the most recent schools you have attend (maximum of three).
School #1*
School #2
School #3
Year Graduated:
Date Expected to Graduate:

MonthDayYear
Date
Ranking in Graduation Class:
If you have a GED Certificate for High School Equivalency, please provide the information below:
Date received GED Certification

MonthDayYear
Date
Upload here your GED Certificate

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If you are a transferree from another college or university or are already enrolled in college/university, please fill out the fields below:
Name of College Last Attended
Academic Year Last Attended
Upload a copy of your transcript.

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College and Career Plans
What college are you planning to attend?*
What is your expected major/minor field of study?*
Awards and Activities
List any distinctions, awards, or honors you have received (may be academic, athletic, or community based):*
List your extra-curricular activities, community service, and hobbies in which you have been involved during the past four years.*

Parental Information
Name of Parent/Guardian*

First NameLast Name
Address of Parent/Guardian*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of Parent/Guardian (different than above)

First NameLast Name
Address of Parent/Guardian (if not the same as above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Essays
What has driven your desire to pursue a degree within the agricultural industry?*

0/0
Describe a personal accomplishment and the strengths and skills you used to achieve it.*

0/0
Describe your career aspirations, passions, and how you plan to achieve them.*

0/0
What does success mean to you?*

0/0
How will you contribute to the academic community at your future college or university?*

0/0

References

Please provide three references (cannot be relatives). Examples of acceptable references could be but are not limited to: teachers, co-workers, employers, coaches, church leaders, etc.
Reference 1
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What is your relationship to this person?*
Reference 2
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What is your relationship to this person?*
Reference 3
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
What is your relationship to this person?*

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 THE APPROVAL OF THIS APPLICATION AND MAY PROHIBIT ME FROM APPLYING AGAIN IN THE FUTURE.
Applicant's Signature*

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Name of Applicant*

First NameLast Name
Date Signed by Applicant*

MonthDayYear
Date
Should be Empty:

Xperience Ag, Inc. College Scholarship Application Form 2026

Educational Information

College and Career Plans

Awards and Activities

Parental Information

Essays

References

Reference 1

Reference 2

Reference 3