ࡱ> DFCa b%jbjbA]A] :+?+?%D <B Ga m,!R<$u^Guuu"8D`,uVE@ ( 0B  $$2011 MORRIS COUNTY 4-H FOUNDATION SCHOLARSHIP Send complete form to Morris County Extension Office, Morris County Courthouse, 501 W Main, Council Grove, Kansas, 66846, by Friday, April 29, 2011. Grantor: Morris County 4-H Foundation The scholarship will be awarded to a present or past Morris County 4-H member, whose residence may or may not be in Morris County. Scholarships may be used at any institution whose goal is to provide further career education. MUST BE ENCLOSED WITH THIS APPLICATION: I. A current picture of yourself (Unattached and suitable for newspaper). II. Transcript of the applicant's high school grades and college transcript (if applicable) are to be attached to this application form. Grades will not be the only determining factor. III. KAA NOTEBOOK---Send a copy of your most recent KAA notebook. You may select the project of your choice. This would include: Kansas 4-H Award Application. Personal Page (from 4-H Record Book). 4-H Story (not to exceed 6 pages, double spaced on one side of paper). A copy of your Kansas 4-H Permanent Record. Pictures (a maximum of 3 pages of photos, one side of paper). Exception - Photography Project. Send copies of 1-5 (listed above). It is not necessary to send the original. Finalist for the scholarship may be asked for a personal interview with the scholarship committee. Winning applicants may win this scholarship a maximum of two (2) years. * * * * * * * * * 1. Name of Applicant:______________________________________ 2. Home Address:_________________________________________________________________________ _____________________________________________________________________________________ 3. Name of Parent or Guardian:______________________________________________________________ 4. Address, if different from application:_______________________________________________________ 5. Parent=s Occupation: Father:______________________________________________________ Mother:_____________________________________________________ 6. Are both parent=s living?__________________________________________________________________ 7. Name of High School or College currently attending:___________________________________________ 8. Address of School:______________________________________________________________________ _____________________________________________________________________________________  Date Signature Page 1  9. I am, or was, in the ___upper ___middle ___lower third of my school class consisting of ______ members. 10. List your extra-curricular activities and interest (such as music, debate, dramatics, sports, FHA, 4-H, etc.): _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 11. List any high school honors you have received (such as editor of the school paper, offices in school organizations, etc.): _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 12. List any community, church or other activities in which you have participated: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 13. Career you are pursuing and location of educational instruction: _____________________________________________________________________________________ _____________________________________________________________________________________ 14. Financial Arrangement: Funds made available after completion and proof of enrollment: Estimated Expenses Estimated Resources Tuition and Books $_______________ Student=s Summer Income $______________ Room & Board $_______________ Student=s School Year Income $______________ Personal Expense $_______________ Parent=s Contribution $______________ Transportation $_______________ V.A. Benefits $______________ Other $_______________ Social Security Benefits $______________ Total College Cost $_______________ Other (scholarships, etc., specify) $______________ Total Resources $______________ Total need: $_________________ (Subtract total resources from total expenses.) 15. Number of brothers and sisters and their ages: ________________________________________________ _____________________________________________________________________________________ Page 2 16. References: Provide both names and addresses. Instructors or anyone outside your immediate family who knows you well. Name:__________________________________________________ Phone: (____)_________________ Address:_____________________________________________________________________________ Name:__________________________________________________ Phone: (____)_________________ Address:_____________________________________________________________________________ 17. Two persons who know your character and ability (other than relatives): Name:__________________________________________________ Phone: (____)_________________ Address:_____________________________________________________________________________ Name:__________________________________________________ Phone: (____)_________________ Address:_____________________________________________________________________________ 18. Write a paragraph telling why you are interested in furthering your education and what ambitions you are wanting to fulfill in the future. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 19. How would the scholarship be beneficial to you? _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Mail to: Morris County Extension Office Morris County Courthouse 501 West Main Council Grove, Kansas 66846 Page 3 Revised 01/2009 Revised 01/2009 Revised 01/2009 Revised 01/2009 This page intentionally left blank / @BEO`a   o q ] ^ iklOP""<%_%b%h/ B*CJ`aJ`phh/ mHnHsHjh/ Uh/ OJQJh/ h/ >*CJaJh/ CJOJQJaJhv'h/ 5CJaJh/ 5CJaJh/ 5CJ\aJh/ CJaJh/ 5CJ\aJ3./n@o 7 I  & F 8^8gd/  ++^+`gd/   0^`0gd/   gd/ $a$$ Ha$"<%a%I J ? T Hil$ `0dh`a$ `0dh` `0dh` `0>dh^`> H4_ a ` bS `0>dh^`> `0dh `0dh` `0 `0>^`>S(uGx $ Hdha$ `0dh^ & F `0dh `0dh `0dh` `0dh` `0 `0>^`>QRWPT9; `0>dh^`> `0dh `0dh` `0 `0>^`>= !s!!" 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Number of brothers and sisters and their ages: _____________________________ Title HeadingsL@ $8@_EmailSubject _AuthorEmail_AuthorEmailDisplayName_AdHocReviewCycleID_ReviewingToolsShownOnce'0October Mailer Scholarshiplviar@ksu.edu Linda Viar47M  !"#$%&'()*+,-./023456789:<=>?@ABERoot Entry F2ҝG1Table$WordDocument:SummaryInformation(1DocumentSummaryInformation8;CompObjX FMicrosoft Word DocumentNB6WWord.Document.8