2017 Tennessee 4-H Scholarship Application Form

Transcription

1 2017 Tennessee 4-H Scholarship Application Form F836 Name (first) (middle) (last) Name you want used in publicity County Home address City/State/Zip Birth Date Age on January 1 of this year Phone At this time, only applications for the AGR and G.L. Herrington scholarships are due March 1. Do not attach additional pages to this application except for those requested in Section V, page 7. I wish to apply for the following scholarship(s): African-American Scholarship AGR Scholarship Alan Peace Memorial Scholarship Arthur Wells Memorial Scholarship Charline H. Powell Scholarship Earl Knepp Agricultural Scholarship Farm Credit Service of Mid-America Scholarship FarmHouse Scholarship Lovelace/McKinney Scholarship Mary Basinger Elliott Memorial Scholarship Mary Stanfill FCS Scholarship Mary Stanfill Memorial Scholarship Richard Shadden Memorial Scholarship Stephen McNeil Memorial Scholarship TEAFCS FCS Scholarship TFGA Mary B. Cooper Scholarship G.L. Herrington Agricultural Scholarship Tennessee Rural Health Nursing Scholarship Gilbert N. Rhodes Agricultural Scholarship Troy & Susie Johnson Memorial Scholarship Harold Robbins Agricultural Scholarship W.B. & Imogene Kyker Agricultural Scholarship Hamilton-Brown Scholarship Statement by 4-H Member I personally have prepared this report and certify that it accurately reflects my work: Date Signature of 4-H Member Approval of This Report We have reviewed this report and believe it to be correct: Date Date Signature Signature (Parent or Guardian) (County Extension Agent)

2 2017 SUMMARY OF REQUIREMENTS - TENNESSEE 4-H SCHOLARSHIPS SCHOLARSHIP AMT* * OFFERED TO STUDIES IN AT SPECIAL REQUIREMENTS African-American Scholarship $300 Freshman Any field of study Any college, university, Limited to African-Americans with a minimum of two consecutive years of 4-H membership AGR Scholarship $500 Freshman Agriculture UTK None Alan Peace Memorial Scholarship $500 Freshman Any field of study Any college, university, Arthur Wells Memorial Scholarship $500 Freshman Any field of study Any college, university, Charline H. Powell Scholarship $1000 Freshman or Sophomore Any field of study Any college, university, Earl Knepp Agricultural Scholarship $600 Freshman or Sophomore Any field of study Any college, university, Farm Credit Services of Mid-America 4-H Scholarship $1000 Freshman Any field of study Any college, university, Limited to 4-H ers from Cannon, Clay, Cumberland, DeKalb, Fentress, Jackson, Macon, Morgan, Overton, Pickett, Putnam, Scott, Smith, Trousdale and White counties Limited to 4-H ers from Western Region. Participation in the sheep project Participation in dairy and engineering/safety science projects None FarmHouse Agricultural Scholarship $500 Freshman Agriculture UTK None Glibert N. Rhodes Agricultural Scholarship $500 Freshman Agriculture UTK or UTM Preference given to 4-H ers majoring in plant & soil science G.L. Herrington Agricultural Scholarship $1000 Freshman Agriculture UTK None Harold Robbins Agricultural Scholarship $300 Student Agriculture UTK Preference given to 4-H ers from Rhea, Pickett, Overton and Fentress counties Hamilton-Brown Scholarship $500 Student Any fiend of study Any college, university, Limited to 4-H ers from Bledsoe, Bradley, Coffee, Franklin, Grundy, Hamilton, Marion, McMinn, Meigs, Monroe, Moore, Polk, Rhea, Sequatchie, VanBuren and Warren counties Lovelace-McKinney Scholarship (renewable for 4 years) $1500/ semester Freshman Agriculture or Family & Consumer Sciences UTK, UTM or UTC Preference given to 4-H ers interested in a career with UT Extension Mary Basinger Elliott Memorial Scholarship $1500 Freshman Any field of study Any college, university, Limited to 4-Her s in Cannon, Rutherford and McMinn counties. Mary Stanfill Family & Consumer Sciences Scholarship $200 Student Family & Consumer Sciences UTK, UTM or UTC None* Mary Stanfill Memorial Scholarship $1000 Student Family & Consumer Sciences UTK, UTM or UTC Participation in family & consumer sciences projects and activities Richard Shadden Memorial Scholarship $250 Freshman Any field of study Any college, university, Steve McNeil Memorial Scholarship $500 Freshman Any field of study Any college, university, Limited to 4-H ers from Carter, Greene, Hancock, Johnson, Sullivan, Unicoi and Washington counties with preference given to those from Washington Count Participation in 4-H animal science projects (horse, beef, dairy, goat, poultry and sheep) TEAFCS Scholarship $500 Freshman Family & Consumer Sciences Any college/university Participation in family & consumer sciences projects and activities TFGA Mary B. Cooper Scholarship $300 Freshman Any field of study Any college, university, Tennessee Rural Health Nursing Scholarship $1250 Student Nursing Any college, university, Troy & Susie Johnson Memorial Scholarship $500 Freshman or Sophomore Any field of study Any college, university, Preference given to 4-H ers pursuing a career in agriculture or related fields Limited to 4-H ers pursuing a degree or certification in nursing Limited to West Tennessee 4-H members. Preference given to those in Chester and McNairy counties W.B. & Imogene Kyker Agricultural Scholarship $250 Freshman or Sophomore Agriculture UTK or UTM Preference given to 4-H ers from Blount and Sevier counties * Preference is to be given to member from certain counties. However, any Tennessee 4-H members or former 4-H member may apply. See the Tennessee 4-H Awards and Recognition Handbook for more details ( ** Amounts may vary on endowment scholarships based on interest earned.

3 I. FAMILY INFORMATION 1. Name and address of parent(s) or guardian(s) City/State/Zip Phone 2. Number of brothers List their ages 3. Number of sisters List their ages Will you have any brothers and/or sisters attending college at the same time you are attending? Yes No If yes, number 4. Father s occupation Age Father s business title Father s employer Phone Mother s occupation Age Mother s business title Mother s employer Phone 5. Do you parents own a business? Yes No 6. Do you parents own or lease farm property? Yes No If yes, number of acres owed leased total List agricultural enterprises: II. SCHOOL, CHURCH AND COMMUNITY 1. Leadership outside 4-H (include school, church, other youth groups, etc.) Year Office, committee, etc. Organization 2. Summarize your major high school activities and honors:

4 III. FINANCIAL DATA 1. A. Available Financial Resources 1. Savings and cash available $ 2. Value of other assets $ a. Livestock $ b Land $ c. Car $ d Other $ B. How did you acquire the above financial assets? C. Additional Anticipated Resources Anticipated aid from parents per semester or quarter $ Anticipated personal earnings from jobs during college $ D. Other scholarship/student financial aid which you have received List: $ $ $ $ 2. Will you liquidate or borrow against the above assets if necessary to pay for your college expenses? Yes No If no, state why. 3. List specific reasons why you need financial assistance. 4. If you do not receive aid, how will this affect your education plans?

5 IV. RECORD OF 4-H EXPERIENCE 1. List the 4-H projects, years involved and size and scope of the activities related to the projects.

6 2. Major 4-H leadership roles - List role, years, level(s), duties and accomplishments H citizenship activities - List activity, year(s), level(s) and your role.

7 V. SCHOLARSHIP VI. Current high school transcript must be attached to this form. A.C.T., S.A.T. and other college entrance test scores may be attached if not recorded on the transcript. College transcript must also be attached if member had completed any college level courses. COLLEGE PLANS 1. University or college you plan to attend Will you live at home? in a dorm? in an apartment? 2. Degree course in which you plan to major (Be specific) 3. In which college/department is this degree course offered? 4. Date applied for admission 5. Have you been accepted? Yes No 6. State specific reasons why you plan to study in this field. (Be specific) VII. CAREER PLANS In the space below, tell about your career choice, why this career was selected and how 4-H may have influenced your choice. Programs in agriculture and natural resources, 4-H youth development, family and consumer sciences, and resource development. University of Tennessee Institute of Agriculture and county governments cooperating. UT Extension provides equal opportunities in programs and employment.