LOGAN COUNTY DAIRY SCHOLARSHIP APPLICATION FORM

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LOGAN COUNTY DAIRY SCHOLARSHIP APPLICATION FORM For an applicant to apply for a Logan County Dairy Scholarship, the following must be submitted to the OSU Extension, Logan County office before March 3 of current year. 1. A completed Logan County Dairy Scholarship Application form (typed or legibly printed). 2. A transcript of official high school grades. 3. A letter of recommendation from a school counselor or academic advisor. All of the above materials should be compiled by the applicant and bound together. There will be two (2) $500.00 scholarships awarded by the Logan County Dairy Association with the winners to be announced at the annual Dairy Awards Banquet and paid to the recipient in August of the award year with proof of acceptance to college or trade school. 1. County District 2. First, Middle and Last Name 3. Age on January 1 of this year Month, Day and Year of Birth 4. Social Security Number 5. Residence: A. Home Address street town zip B. Home Telephone Number ( ) C. Place of Residence (check one) Farm acres Town under 10,000 and open country Town or city 10,000 to 50,000 D. School street town zip E. School Telephone Number ( ) 6. Family: A. Name and of father Living: Yes No Occupation B. Name and of mother Living: Yes No Occupation C. Name and of guardian

D. Number of brothers Number of sisters E. Ages of all brothers and sisters 7. Dairy Experiences: In the spaces provided, explain your accomplishments in the dairy field, the impact dairying has made upon you and your family, what impact you have been able to make (as a result of your dairy work). A. Number of years in dairying (2 pts.) B. Major dairy projects: (5pts.) C. Major accomplishments through dairying: D. Other leadership experiences: E. Special dairy activities and experiences: F. Major honors received through dairying: (3pts.) Points Scored /34

G. The most important things you have learned through dairying and the impact dairying has made upon your plans for the future: (10pts.) 8. Experiences in other groups and activities: In the spaces provided, show your involvement in other groups and in other interests as well as evidence of impact of what you have done. A. School (3pts.) B. Community (3pts.) C. Church (3 pts.) D. Hobbies (2 pts.) E. Special Interests (3 pts.) Points Scored /24

9. Future plans and potential for success A. Academic preparation I. Year in school High School, Date of Graduation Technical or Trade School: Year Date of Graduation College: Freshman Major Sophomore Junior Senior Date of Graduation Graduate Degree ii. Name and of high school, college or trade school you are now attending: street town zip iii. If a high school graduate, and of high school attended: street town zip iv. Scholastic average out of points. (3 pts.) v. College, university or trade school attended beyond the high school level: Dates of Credits Name of Institution Attendance Earned Scholastic Average B. Describe why you are interested in pursuing a college education: (7 pts.) C. Field in which you are majoring or plan to major: D. Outline your reasons for choosing this field of study: (20 pts.) Points Scored /30

E. College or University you plan to attend: 10. Need for a dairy scholarship: A. Explain your need for financial assistance to continue your college education during next year and describe your plans for meeting this financial need. Include your plans for self-support and aid from your family. Mention any special or unusual financial needs. (4 pts.) B. List anticipated college costs for the next year: Tuition Fee $ Board $ Lab Fees $ Room $ Personal Expenses $ Books $ Clothing $ Transportation $ Other $ (2 pts.) C. Will you have any brothers or sisters attending college or trade school during the next year? Yes No If yes, explain: (2 pts.) D. Have you been chosen or are you being considered for any other scholarships for the next year? Yes No Name of Scholarship Amount Being Considered or Been Chosen (2 pts.) E. Will you be receiving or have you applied for any educational loans for the next year? Yes No Loan Institution Name Amount Have Applied or Will Receive (2 pts.) I have personally prepared this application and believe it to be correct: Date Points Scored /12 Signature of Applicant TOTAL POINTS SCORED /100