OHIO STATE UNIVERSITY EXTENSION

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WYANDOT COUNTY 4-H SCHOLARSHIP COURTRIGHT SCHOLARSHIP INDIAN MILL ANTIQUE ASSOCIATION SCHOLARSHIP I & D SCHOENBERGER FAMILY SCHOLARSHIP APPLICATION FORM PRESCREENING: Applications MUST include ALL of the following items to be considered. All required application items are due in the Extension Office by April 1. 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 Transcript School Reference Advisor Reference Qualifications are: 1. Available to 4-H members from Wyandot County who are seniors in high school and who are enrolled in an accredited college or technical school. 2. Scholarships will be given after satisfactory completion of one quarter or semester of college. 3. Applicant must be a current 4-H member the year that the scholarship is received. (This requires project completion, but not necessarily displaying at the fair.) 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 involved in 4-H and 1 point per project (i.e. project market hogs for six years it only counts as 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. The Courtright Scholarship and the Indian Mill Antique Association Scholarships require that preference be given to applicants who are planning to major in the field of agriculture. Two I & D Schoenberger Family Scholarships will be given. Preference will be given to one female student and one male student. 7. Selections will be made in the spring of the year. 8. Selections will be based on written application. 9. Pages 1-3 are to be completed by 4-H applicant. Remember to attach a photo. 10. Page 4 is to be completed by the school principal or guidance counselor. 11. Page 5 is to be completed by applicant's 4-H Advisor.

WYANDOT COUNTY 4-H SCHOLARSHIP APPLICATION FORM Due April 1 Name Date Address Street or Road City State Zip Home Phone Male or Female Birth Date Present Age High School Date of Graduation Course Taken Rank in Class No. in Class What College, University, or Technical School do you plan to attend? Field of Study Name of Parent or Guardian Address of Parent or Guardian Occupation Number of Brothers: older younger Number of Sisters: older younger How many people are dependent on your parents for support? How do you plan to finance your college education? Name of 4-H Club as of May 1 of this year List 4-H projects taken this year

Page 2 Name PARTICIPATION IN 4-H Number of years as member Club Projects completed: 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 County Activities (i.e. camp counselor, CARTeens Presenter, Junior Fair Board):

Page 3 Name 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 Name SCHOOL INFORMATION: Due April 1 Give this sheet to your principal or counselor after placing your name on the line below. 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 scholarship of applicant: Leadership exhibited in extra curricular activities. Personal observations on attitude, ability or anything else that would be pertinent. Signed When completed, return form to: OSU Extension, Wyandot County Title 109 S. Sandusky Avenue, Room 16 Upper Sandusky, OH 43351-1423 Do not return this form to the applicant.

Page 5 Applicant's Name ADVISOR INFORMATION: Due April 1 Give this sheet to your 4-H Advisor. Name is a member of Club for years. Describe project work: Leadership in the local club: Willingness to accept responsibility: Worthiness of scholarship: 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.