Darrell and Jane Tissot 4-H Endowment Fund Scholarship

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Egbert McGee
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1 Darrell and Jane Tissot 4-H Endowment Fund Scholarship One $1, college scholarship will be awarded annually to a current Highland County 4-H member who is a graduating senior or an Alumni of the Highland County 4-H Program, enrolled in any accredited College, University, or two year degreed program, nursing or technical school. This $1, College Scholarship may be renewed annually for the next three years (sophomore, junior, senior) with reapplication and showing a GPA of 2.5 or better in addition to submitting a renewal application by correct date. For an applicant to apply for this scholarship, the attached application must be completed and submitted in a folder to the Highland County 4-H Office. The application must be typed or legibly printed in black ink and include the following: 1. A transcript of high school grades. If the applicant is a high school senior, grades through at least the 1 st semester of their senior year should be included. 2. If a current college student, a transcript of the current grades and accumulated grade point. 3. One portrait photo, glued to a separate sheet of paper with the applicant s name, address and school beneath the photo. 4. A hand written letter from the applicant explaining why they should be considered for the scholarship. The selection of scholarship winners will be a responsibility of the Highland County 4-H Committee and the scholarship donors. The criteria that will be used in the selection of the winner will include: 4-H Experiences 20% School, community, & church activities 20% Academic accomplishments & potential for success 30% Consideration of financial need 30% Completed applications must be submitted by February 16, 2017 for the following college year. Return to: Ohio State University Extension, Highland County 4-H 119 Governor Foraker Place, Suite 202 Hillsboro, OH Don t forget to sign it!

2 APPLICATION FORM for the 2017 Darrell & Jane Tissot 4-H Endowment Scholarship Name of Applicant Social Security Number Address Birth Date (Mo/Day/Year) Home Telephone Number Address cell phone number High School Attended Year of Graduation GPA College Planning To Attend: If currently enrolled in college: Name of College College Address College Phone Number Address Major Field of Study 1. Family A. Name and Address of Father B. Name and Address of Mother C. Name and Address of Guardian (if appropriate) D. If Married - Name of Spouse Number of Children Ages E. Number and Ages of Brothers Sisters

3 2. 4-H Experiences A. Number of years enrolled as a 4-H member B. Favorite 4-H Project: C. 4-H Club belonged to: D. I am glad I participated in 4-H because: 3. Experiences In Other Groups And Activities: Show your involvement in other groups and in other interests, and any impact that you have caused. A. School: B. Community: C. Church: D. Hobbies: E. Work or Job:

4 4. Future Plans and Potential for Success: A. Scholastic and Schools Attended: 1. Name and address of high school or college you are now attending: 2. If a high school graduate, name and address of high school attended: B. Describe why you are interested in pursuing a college education: C. Field in which you are majoring or plan to major: D. Outline your reasons for choosing this field of study: E. Are you currently receiving any scholarships from any other sources?

5 F. Are you anticipating any college scholarships from the college of your choice for athletics or academics? Yes No Explain G. Will you be receiving or have you applied for any educational loans? Yes No Name of Lending Institution Owed $ Total Amount H. What are your anticipated costs for attending college the current year? Tuition Fees $ Board $ Room $ Books $ Lab Fees $ Clothing $ Transportation $ Other $ Please explain: I. Amount of support you expect to receive from your family for coming school year $ J. College You Plan To Attend I have personally prepared this application and believe it to be correct: Signature of Applicant Date of Application Signature of Parent, Guardian or Spouse (if married) Date Signature of 4-H Advisor or OSU Extension Educator Date

OHIO STATE UNIVERSITY EXTENSION

OHIO STATE UNIVERSITY EXTENSION WYANDOT COUNTY 4-H SCHOLARSHIP COURTRIGHT SCHOLARSHIP INDIAN MILL ANTIQUE ASSOCIATION SCHOLARSHIP I & D SCHOENBERGER FAMILY SCHOLARSHIP APPLICATION FORM PRESCREENING: Applications MUST include ALL of the