Travis Lynch Memorial Scholarship Application

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1 Travis Lynch Memorial Scholarship Application Eligible students include high school seniors who plan to attend a college, university, or technical school. The scholarship will be reviewed with a focus of 30% emphasis on grades and academic standing, 50% emphasis on extracurricular activities, and 20% emphasis on financial need. This scholarship rewards students that have been involved with a BREEDING DIVISION of the Karnes County Youth Show. All applicants must have exhibited a breeding animal in the calendar year of which they apply for the scholarship. If a student was not eligible to show due to grades they are not eligible to apply for the scholarship. Application Procedure Applications are furnished directly to individuals, high schools, Ag Science Teachers and County Extension Agents. Copies of the application can be sent directly to the individual by calling the Karnes County Extension Office at Applications should be completed in full and must be typed or printed neatly in black or blue ink. Incomplete applications will not be accepted for consideration and will be returned. All applications must be sent to: Travis Lynch Memorial Scholarship 210 W. Calvert, STE 160 Karnes City TX Applications must be received no later than Monday, April 1, 2013 at 4 pm. 4-H or FFA requirement The applicant must be an active member in good standing of 4-H or FFA. Involvement will be verified by the County Extension Agent. Activities Leadership potential and character of the applicant should be demonstrated through the applicant s responses on the application detailing school, extracurricular, community and KCYS activities and achievements. A one page list of activities or a one-page resume may accompany the application. Documentation Each application must be accompanied by an official transcript showing academic average and grade scale through four years of high school, class size, and official ranking of applicant; proof of ACT/SAT scores; certification of 4-H/FFA membership. Deadline Applications must be received by the Karnes County Extension Office by Monday, April 1, 2013 at 4 pm. NO EXTENSIONS WILL BE GRANTED! Applications will not be returned after judging and become the property of the Travis Lynch Memorial Scholarship. Evaluation Procedure For the purposes of evaluation of applicants, the Karnes County Youth Show Board of Directors will arrange a selection committee to review all properly completed applications. Final approval and notification of each scholarship recipient will be made prior to the May Karnes County Youth Show Board meeting. The scholarship payment will be issued after documentation of the student s enrollment has been verified. Any interpretation of final guidelines will fall under the advisement of the Karnes County Youth Show Board of Directors.

2 : Scholarship Application Circle One Full Name of Applicant: Male Female Preferred Name: Address: City: Zip Code: Phone: of Birth: Age: FAMILY INFORMATION Father s Name: Age: Father s Occupation: Father s Place of Employment: Daytime Phone Number: Mother s Name: Age: Mother s Occupation: Mother s Place of Employment: Daytime Phone Number: Check the applicable blank: I live at home with both parents. I live in a single parent household with my. Other: Please explain if you live with a guardian, grandparent, or have other arrangements. Number of Siblings: Ages: Number of Siblings in College Now:

3 ACADEMIC INFORMATION Name of High School: City: Phone: Anticipated Graduation : Number in Graduating Class: Class Rank: of Ranking: GPA (100 pt scale): SAT SCORE ACT SCORE: of Exams: Please list any advanced classes, Honors Classes or Dual Credit classes taken: BEGINNING COLLEGE INFORMATION Have you applied for admission to a college, university, or technical school? Have you been accepted? Name of College, University, or Technical School: Major Field of Study: Planned Career Path: INVOLVEMENT Are you currently an active member of 4-H or FFA? YES Please list number of years in each organization(s): 4-H NO FFA Name of Club or Chapter: ACTIVITIES, HONORS, AWARDS Include a one page list of all honors, activities, awards, offices held in your school, club, and community separate from this application. GREATEST PERSONAL ACCOMPLISHMENT

4 Karnes County Youth Show Involvement: FINANCIAL INFORMATION Indicate approximate cost per semester at the school in which you will attend. Please indicate tuition, fees, books, housing, etc. as separate items. Name of School you will attend: Tuition per Credit Hour: Fees per semester: Housing per semester: Will you live in the dormitory? Describe how this scholarship could help you financially in the space below.

5 CERTIFICATION OF APPLICATION Ag Science Teacher or County Extension Agent I have examined this application and find the records to be true, accurate, and complete. Furthermore, all required documentation is attached. AST or CEA Printed Name AST or CEA Signature Phone Number CERTIFICATION BY APPLICANT AND AUTHORIZATION FOR VERIFICATION I hereby certify that the statements contained in this application are true, accurate and complete and that I presently meet all eligibility requirements set forth in this application. If selected to receive this scholarship, I understand that I am expected to enroll in a college, university, or technical school and will not receive awarded funds until such action has been verified. Any false statement in this application shall constitute grounds for revocation or withdrawal of any awarded scholarship. I hereby authorize any person, firm or entity to release to the Karnes County Youth Show Board of Directors, or their authorized representatives, information concerning the subject matter of the statements I have made in this application including, but not limited to, information concerning my academic record, activities, honors, and awards and financial situation. A copy of this authorization is agreed by the undersigned to have the same effect and force as an original. Any person, firm or entity releasing matters pursuant to this authorization is hereby absolved from any liability. Applicant Signature Parent Signature

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