Please staple your photo to this provided area SCHOLARSHIP APPLICATION Deadline: December 1, 2017

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1 Please staple your photo to this provided area SCHOLARSHIP APPLICATION Deadline: December 1, 2017 Applications must be postmarked by the deadline and mailed to: Oklahoma Youth Expo, 500 NW 30th Street, OKC, OK We HIGHLY recommend sending your application by certified mail. First Name Last Name Address Cell Phone Number City Home Phone Number Name of FFA Chapter or 4-H Club Specie(s) you will be showing at the 2018 OYE Number of years competed at OYE Birthdate State Zip Parent s Names Name of Agricultural Education Instructor / County Extension Educator GPA Student s Address (Majority of communication will be done via ) Jacket Size (S, M, L, XL, XXL) I will be a full-time college student in the fall of Yes Are you PQA certified? Yes/No No I plan to attend one of the following schools (If undecided at time of application, select all schools in which you are considering) Oklahoma State University Southwestern Oklahoma State University Redlands Community College Cameron State University Connors State College Northwestern Oklahoma State University Northeastern Oklahoma College Murray State College Eastern Oklahoma State College Other; please list

2 I plan to pursue a degree in the medical field (Please see descriptions of our OSU Health Sciences Scholarship & Blue Cross Blue Shield Scholarship at Yes No My major field of study will be: Please use information from most recent tax forms filed with the IRS. 1. Estimated educational expenses $ / year 2. I am a dependent. I am independent. (If dependent, go to question 3. If independent, go to question 5.) 3. Number of family members including myself 4. Number of family members attending college Applicant/Student Parent/Guardian 5. Personal income from non-farm employment as stated on most-recent tax forms $ $ 6. Net farm income or (loss) $ $ 7. Other sources of income to assist in college expenses $ $ 8. Family contribution to estimated college expenses $ $ 9. Please explain any unusual circumstances (emergency or medical expenses, debts on farm or business, etc.) 10. Please list any scholarships or monetary academic awards received as of application deadline date.

3 Please indicate if you are a certified member of a federally recognized tribe, and if so, which tribe. Yes No Tribe Please list the name of your family banking institution: Please list most significant 4-H and FFA leadership positions using only the bullets provided. Please list most significant 4-H and FFA awards using only the bullets provided. Please list most significant show ring accomplishments using only the bullets provided. Please list most significant community leadership activities using only the bullets provided.

4 Please Note: Essay #1 and Essay #2 are required for all scholarship applications. All essays must be double-spaced and typed in Times New Roman, 12-point font. Essay #1 Attach a short essay (maximum 500 words) on how the Junior Livestock Program has contributed to your higher educational and career pursuits. Essay #2 Attach a short essay (maximum 500 words) on your ten-year goals in life and how those pursuits will help make the state of Oklahoma a better place. Transcript Attach a current copy of your official high school transcript including a current class ranking. Resume Attach a one-page resume that includes the following sections: Name/Address/Phone Number/ Address/FFA Chapter or County 4-H Club Career Objective Education 4-H / FFA Leadership Activities/Awards School Leadership Activities/Awards Community Leadership Activities/Awards Professional Associations Other Accomplishments References Application (IMPORTANT!) Applications need to be STAPLED together at the top left hand corner. Do not submit applications in any type of binder or folder. Please provide FIVE COMPLETE COPIES of your application these will be distributed to each of the judges on the scholarship committee. Local Newspaper Name: Newspaper s Address: Newspaper s Fax Number:

5 I hereby certify that the information submitted on this application by the applicant is true and correct to the best of my knowledge. I have reviewed this application for any misinformation and have found none. If misinformation is found, I may be held accountable for the student s disqualification. (AEI=Agricultural Education Instructor, CEE=County Extension Educator) AEI or CEE First Name AEI or CEE Last Name AEI or CEE Signature (Required) Applicant Signature (Required) Date Parent(s) / Guardian(s) Signature (Required) Date