Monroe County Extension & 4-H Education Foundation

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1 SCHOLARSHIP Application Criteria Applicants must be seniors in high school and/or have not reached their nineteenth birthday on or before September 1, Applicants must have been enrolled and active in a 4-H club program for at least four consecutive years. The applicant must be a resident of Monroe County and/or attend the Waterloo, Columbia, Valmeyer or Red Bud School district. 4-H members can only receive the Scholarship once. Applicants must be accepted into or be attending a post-high school education program. Applicants must thoroughly complete the application, following the guidelines and submit a 4-H club leader and another character reference. The application must be completed using a Word processing computer program. Recipients must provide information on the Office of Student Financial Aid Form where the scholarship check will be sent. The applicant must submit a one-page report by December 31, indicating continued enrollment and describe how their educational career goals are progressing The application must be signed by the applicant. The scholarship award is up to $1,500 per recipient. Completed applications must be postmarked by April 13, Faxed applications will NOT be accepted. Applications should be sent or delivered to: University of Illinois Extension, P. O. Box 117, Waterloo, IL A recognition reception will be held in May for the recipients, parents/guardians, and friends. This scholarship fund was established in February 2002, by memorial funds from the family and friends of Wilbert Sensel. Additional contributions continue to support the scholarship. The scholarship will help young people enrich their lives through continuing education.

2 Scholarship Application Application must be prepared using a word processing program. Part I: General Information to be included: 1. Full Name, Date of Birth 2. Complete Home Address 3. Telephone number and address 4. Current High School/College/Trade School 5. Date of Graduation 6. Father s name in full 7. Mother s name in full 8. Applicant Signature Part II: 4-H Project/ Program Summary Year Name of Project/ Program Project/ Program Size or Scope (what I made, did, raised, or cared for, #taught/ mentored) Part III: Participation in Other Community/ School Activities/ Events Year Kind of Activity What I Did and Skills Learned

3 IV: Participation in 4-H Events/ Activities Year Kind of Activity What I Did and Skills Learned

4 Part V: Academic Plans-10 points 1. Name and location of the college, university or vocational school(s) where you plan to or are attending. 2. Briefly state what your major field of study will be. 3. Describe other employment plans/scholarship(s) to help financially support your continuing education. 4. What are your career goals? Part VI: Tell your 4-H Story Describe the impact your 4-H experience has made on you and/or others. Depending upon your experience, this could include, but is not limited to, items such as the following: Project responsibility knowledge and skill development Impact of your project and community service on your community Results of teaching or mentoring youth in various subject matter areas Explaining challenges faced and what was learned in overcoming those challenges The influence 4-H involvement has had on your future goals, etc. Judging Rubric Section Criteria Eligible Points 4-H Project/ Program Illustrate Growth in Projects or Programs 30 Summary during 4-H years (30) Participation in Other Community/ School Activities/ Events Participation in Activities (6) Leadership Exhibited (6) Community Service (6) Knowledge/Skills Gained (6) 30 Participation in 4-H Events/ Activities Advanced Levels of Involvement (6) Participation in Activities (5) Leadership Exhibited (10) Community Service (10) Knowledge/Skills Gained (10) Advanced Levels of Involvement (10) Academic Plans Explain post high school education training location and career goals (10) Tell your 4-H Story Personal impact of 4-H involvement (25) Successes & Challenges (20) Influence on Future Goals (10) Leadership Demonstrated (10) Signature, complete & accurate: spelling, punctuation, grammar (10) Recommendation Letter Provide two recommendation letters 10 TOTAL POINTS

5 Scholarship Application 4-H Club Leader Character Recommendation Applicant Name 1. Describe how you know the applicant. 2. Describe the character strengths of the applicant. 3. Describe the applicant s leadership growth through their 4-H involvement. 4. Why do you believe this applicant should be awarded a Monroe County Extension and 4-H Education Foundation Scholarship? Signature: Name: Address Phone Date: Return completed reference by April 13, 2018 to: University of Illinois Extension, P.O. Box 117, Waterloo, IL 62298

6 Scholarship Application (To be completed by a community leader/volunteer (teacher, coach or mentor)) Applicant Name 1. Please describe the character strengths of the individual. 2. Additional comments: Signature: Name: Address Phone Date: Return completed reference by April 13,2018 to: University of Illinois Extension, P.O. Box 117, Waterloo, IL 62298

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