Application Deadline -- March 11, Please note, this application has been updated and this is the only application that will be accepted.

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1 $ Brown County Pork Producers Scholarship or $ Grace Murphy Scholarship (Applicants will be contacted if chosen to interview for the Grace Murphy Scholarship) Note: Interviews for the Grace Murphy Scholarship will be held Thursday, April 21 st starting at 4:30 p.m. in the Agricultural Science classroom (Mr. Rosselot s classroom) at Western Brown High School. Mail Application To: Brown County Pork Producers c/o Lory Rosselot, Secretary 2888 State Route 131, Fayetteville, Ohio Application Deadline -- March 11, 2016 Please note, this application has been updated and this is the only application that will be accepted. Purpose The Brown County Pork Producers will be awarding scholarships to high school seniors who will graduate during the 2015/2016 school year or a previous 4-H or FFA member currently attending college. These scholarships have been established to assist young people in their efforts to pursue a college education. Criteria and Selection Procedures The applicant must reside in Brown County or attend a Brown County high school. Applicants must be a current or previous 4-H or FFA member and must pursue a college or technical school degree. Selection Process Criteria Agriculture/Livestock related background 20% Future plans 20% School and community activities 30% Need for scholarship 30% A scholarship committee will sort the applications down to a limited number of finalists. Applicants will be required to present 1 st quarter/semester grades prior to receiving scholarship funds. Grades along with other appropriate information (i.e., name and mailing address) should be mailed to Lory Rosselot at the above address.

2 Page 1. GENERAL INFORMATION Are you currently involved in 4-H or FFA? Yes No How many years have you been involved in 4-H or FFA? 4-H, FFA Type of 4-H or FFA Project(s): Do you currently take a swine project to the county fair, Yes No If no, please list last year swine project(s) was taken: 4-H and/or FFA Advisor s Name: A. PERSONAL Name Home Address Home Phone and/or Cell Phone Number (this will be the # used for contacting interview candidates) County Date of Birth B. FAMILY Parent s Names Address Occupations Number of Brothers Number of Sisters Any brothers or sisters currently attending college? If so, how many? C. SCHOOL School Attending School Address Telephone Number

3 Page 2. SCHOOL AND COMMUNITY ACTIVITIES In the spaces provided, show your involvement in various school and community activities. Indicate any offices held. A. SCHOOL B. COMMUNITY C. CHURCH D. HOBBIES E. SPECIAL INTERESTS

4 Page 3. AGRICULTURE/LIVESTOCK RELATED BACKGROUND In the space provided, explain your background and various experiences in agriculture. Do you currently live on a farm? If so, describe your family s farming operation. Is your family directly involved in livestock production? If so, describe the scope of production and your involvement in the process. In a few words, describe the importance of agriculture and livestock in your county and the future you foresee for agriculture and livestock production.

5 Page 4. FUTURE PLANS A. ACADEMIC PREPARATION Name of High School Attended Date of Graduation Scholastic Average Ranked in a class of *Note: Applicant must submit a copy of his/her transcripts signed by the high school guidance counselor (attach to scholarship application) B. Describe why you are interested in pursuing a college or technical school education. C. Field in which you are planning to major and your reasons for choosing this field of study. D. College, University, or Technical School you plan to attend.

6 Page 5. NEED FOR THE SCHOLARSHIP A. Explain your need for financial assistance to obtain your goal of a college education. Include your plans for self-support and from your family. Mention any special or unusual financial needs. B. List anticipated college or technical school costs for the next year. C. Have you been chosen or are you being considered for any other scholarships? Yes No Name of Being Already Scholarship Amount Considered Chosen