Scholarship Application Form

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1 Country Visions Cooperative CP Feeds, LLC 709 Mill Street, P.O. Box West Washington Street Reedsville, WI Valders, WI Scholarship Application Form Country Visions Cooperative and CP Feeds, LLC are pleased to announce that we will be offering scholarships to area students. A total of 20 area students will each receive a $1,000 scholarship awarded through this partnership of our companies. Eligibility: 1. The 2018 graduating high school senior must be enrolled for the upcoming school year in an undergraduate degree program by an accredited college or university, or planning to attend a vocational or technical school. 2. The parents, parent, or legal guardian of the student must be a member of Country Visions Cooperative and have purchased at least $2000 worth of goods and services in the year prior to application from Country Visions or CP Feeds. 3. Applicant must have a minimum cumulative grade point average of 2.75 on a 4.0 scale during their previous educational years. Entry Requirements: 1. Complete the application form and return to Country Vision Cooperative along with all requested documents. 2. Attach a transcript from your high school through your most recently completed semester. 3. Include two letters of recommendation. (At least one should be from an employer, community leader, teacher or principal) 4. If chosen as a scholarship winner, the student will need to complete one (1) semester of college or technical school to receive the funds. After

2 successful completion of a semester of college, students must submit a copy of their grade report and proof of enrollment for second semester. 5. If you are awarded a scholarship, you will be asked to furnish a photograph of yourself for publication. High resolution digital photos will also be accepted. Deadline: Applications, including all required data, must be postmarked, ed or delivered to Country Visions office by March 31, 2018 without exception. Return to: Country Visions Cooperative c/o Judy Schuh or jschuh@cvcoop.com 709 Mill Street, PO Box 460 subject: scholarship Reedsville, WI Judging: The combined Country Visions Cooperative and CP Feeds, LLC Scholarship Fund Selection Committee has sole authority for granting scholarship awards. Scholarship recipients will be selected on the basis of academic performance, recommendations, essay question response, extra-curricular activities, employment experience and completion of application. Preference will be given to students majoring in agriculture. All applicants selected as finalists may be subject to a personal interview with representatives of the Selection Committee. Finalists and their schools will be notified during May All selections are considered final. All applications and attachments become the property of Country Visions Cooperative and CP Feeds, LLC Scholarship Committee.

3 Country Visions Cooperative CP Feeds, LLC 709 Mill Street, P.O. Box West Washington Street Reedsville, WI Valders, WI Scholarship Application Form Please type or print in the form below 1. Personal Information Name: Date of Birth: Permanent Address: City: State: Zip: County: Telephone No.: Name of Parent(s) or Guardian: DBA or Farm Name Country Visions Account Number: Name of High School: Year of Graduation: Rank in Class(i.e. 15/210): College, University or Technical School: Major or General Field of Study: Please attach additional pages as needed to complete sections 2 and Demonstration of Leadership, Scholastic Achievement, Activities and Goals

4 Please list extracurricular and community activities in which you have participated. Include offices and leadership positions held in all organizations, including church, school, clubs, etc. List all awards and honors received, including fairs and shows. Have you received or do you intend to apply for other scholarships? Yes No If yes, which scholarship(s) have you received? Indicate the name, agency granting it, and amount. List any work experiences you have had during high school:

5 3. Essay Write a personal essay about yourself including a) significant events of your life, b) describe your educational goals and future career plans, c) additional information about yourself you wish to share that might be relevant to this application. (Please limit essay to one page) 4. References Please submit two letters of recommendation in support of your application. In addition, list their name, occupation, and phone number below. The completed letters of reference MUST be submitted with this application. Name Occupation Ph. Name Occupation Ph. 5. Confirmation I hereby confirm that the information contained in this application is true to the best of my knowledge. Signature Date

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