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WYANDOT COUNTY 4-H GRANT Wyandot County 4-H believes that education is a lifelong journey that does not follow one set pathway. Knowing this, the Wyandot County 4-H Endowment Committee has dedicated themselves to offering a new way to support 4-H members who seek to further their skills and education but choose to not attend a specific degree-granting program. The Wyandot County 4-H Grant is reserved for individuals looking to complete a certificate, join a journeyman s program, or pursue other educational endeavors that do not include a specific degree. APPLICATION FORM INSTRUCTIONS: Applications MUST include ALL of the required items to be considered. All required application items are due in the Extension Office by April 2, 2018. Some earlier school deadlines may apply. Applicant is responsible for verifying their school s requirements for completion of this application. It is the applicant s responsibility to verify that ALL application items have been received. Check List: Application Photo School Reference 4-H Advisor Reference Transcript Qualifications are: 1. Available to 4-H members from Wyandot County who are seniors in high school and who will be joining a training program or non-degree granting educational program following graduation. 2. Grant money will be awarded after proof of enrollment and verified success in selected program. 3. Applicant must be enrolled as a 4-H member the same year that the grant is received, complete at least one project and be a member in good standing. Displaying at the fair is optional. 4. Applicant must also have been a member of the Wyandot County 4-H program during the previous three years. 5. Applicants will be selected on the basis of: 40% - 4-H participation 1 point per year enrolled as a 4-H member and 1 point per completed project (Note: any project taken for multiple years counts as only one project). 35% - Leadership in 4-H 1 point per local 4-H club officer position; 2 points each serving as Wyandot County 4-H Camp Counselor, CARTEENS Presenter, Youth Member of Wyandot Co. 4-H Advisory Committee, Wyandot Co. 4-H Endowment Committee, Wyandot Co.4-H Horse Committee, Wyandot County Jr. Fair Board or Assistant; and 1 point per officer position on Wyandot County Jr. Fair Board. 15% - Scholastic Achievement: the cumulative GPA as it appears on transcript (i.e. 3.5) 10% - Community Activities 6. Selections will be made in the spring of the 2018. 7. Selections will be based on written application. 8. Pages 1-3 are to be completed by 4-H applicant. Remember to attach a photo. 9. Page 4 is to be completed by the school principal or guidance counselor. 10. Page 5 is to be completed by applicant's 4-H Advisor.

Personal Information: WYANDOT COUNTY 4-H SCHOLARSHIP APPLICATION FORM Due April 2, 2018 Date Address Street or Road City State Zip Home Phone Birth Date High School Male or Female Present Age Date of Graduation 4-H Club Information: of 4-H Club You Intend to Join as of April 2, 2018 **You must be enrolled in 4-H in the year the grant is received (2018), complete at least one project and be a member in good standing Contact Information: Parent(s) or Guardian(s) Address of Parent(s) or Guardian(s) Phone Number of Parent(s) or Guardian(s) Program Information: What program, training, or certificate do you plan to pursue? What are your long-term career aspirations?

Page 2 PARTICIPATION IN 4-H (Use additional sheets of paper if needed) Number of years as member including 2018 Club(s) Projects completed (though previous year end 2017): Special awards for projects: Leadership in local club: (Officer and/or committee chair) County Activities: Participation in county events (i.e. 4-H camp): Leadership in 4-H Activities County or State (i.e. 4-H camp counselor, CarTeens Presenter, Junior Fair Board, State Ambassador, Teen Leadership Team):

Page 3 OTHER ACTIVITIES Indicate participation in the respective organizations by a check. If you were an officer or held some other leadership role, indicate position held, etc. Describe important activities, honors or recognition received in the organizations. ORGANIZATION Freshman Sophomore Junior Senior High School Class Officer School Organizations i.e., Band, Sports, SADD, Language Club, FFA, Farm Bureau, etc. Church Other Youth Groups Others

Page 4 Applicant's SCHOOL INFORMATION: Due April 2, 2018 Give this sheet to your principal or counselor after placing your name on the line above. NAME will graduate from High School (date of graduation). Student's actual or estimated rank is of in the class. Please attach a transcript of scholastic records of the applicant to this form. Accomplishments and honors reflecting performance of applicant: Leadership exhibited in extracurricular activities. Personal observations on attitude, ability or anything else that would be pertinent. Signed Title When completed, return form to: OSU Extension, Wyandot County 109 S. Sandusky Avenue, Room 16 Upper Sandusky, OH 43351-1423 Do not return this form to the applicant.

Page 5 Applicant's ADVISOR INFORMATION: Due April 2, 2018 Give this sheet to your 4-H Advisor after placing your name on the line above. Is a member of Club for years. Describe project work: Leadership in the local club: Willingness to accept responsibility: Worthiness of grant: Advisor's Signature When completed, return form to: OSU Extension, Wyandot County 109 S. Sandusky Ave., Room 16 Upper Sandusky, OH 43351-1423 Do not return this form to the applicant.