NORTH CAROLINA 4-H

SCHOLARSHIP APPLICATION

Name

______

Last First Middle

Name to be used for publicity:______

Sex M _____ F _____

Home Address ______

______

City ______State ______Zip ______

Telephone ( ) ______

County of Participation ______

Parents/Guardian name: ______

(As you wish to be used for publicity)

High School last attended:

______

Name Name City

Dates of Attendance Date of Graduation

______

College(s) to which you are applying for admission (or are enrolled)

Circle the college(s) you have been accepted to.

______

______

Intended Major ______

Birth date ______/______/______

Month Day Year

Hometown newspaper ______

______

Address of newspaper ______

______

Are you an active 4-H Club member? ______

Are you participating in project work? ______

Number of years in 4-H ______

Directions for the nominee:

Turn in 4 completed application packets – 1 original and 3 copies (for judging purposes only)

***1. Refer to the Awards Handbook for eligibility guidelines.

2. Please place a check (X) on the line for all scholarships for which you are applying. Note eligibility requirements. All information will remain confidential.

3. Be sure that you have filed an application for admission to at least one accredited North Carolina College and be certain to arrange for and take the College Entrance Examination Board Scholastic Aptitude Test or ACT assessment. It is the nominee’s responsibility to make all arrangements for college admissions.

4. Parents/Guardians may submit a confidential letter stating special finance concerns. It should be placed in an envelope and sealed before including it in the application package. Please label the envelope “confidential.”

5.Submit a black and white or color photograph to an 8 2 x 11 sheet of paper. Include your name, county, and the names of the scholarships for which you are applying on the photograph page. Place this in the front of your application packet.

6. A high school transcript listing SAT or ACT scores should be included in the scholarship package. One original transcript must be submitted.

7. Submit one letter of recommendation based on academic achievement and one letter of recommendation based on 4-H accomplishments.

8. Submit resume.

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NORTH CAROLINA 4-H

SCHOLARSHIP APPLICATION

* Denotes Renewable Scholarship – must provide a current Transcript and be entered electronically each year.

Scholarship Name: / Place check in box for each scholarship you are eligible for:

Non-Restricted 4-H Scholarships

* LR Harrill /

X

Dr. Clarence Poe / X
NC 4-H Development Fund / X

Restricted 4-H Scholarships

Edmund & Elizabeth Aycock
Anne Kristine Barnes
Joe and Barbara Brooks
Dr. David and Mrs. Carol Burnette (West District)
Geraldine Kennedy Capps
Thomas A. Carter Family 4-H Poultry
Dr. Eloise Cofer 4-H (Family & Consumer Science)
Victoria Jean Cope
Reece and Jessie Crouse NW
Dr. Gary S. & Patricia H. Davis
*Rudolph Carl Ellis
Edward Gore/General Hugh Shelton Leadership
Huddleston Family 4-H Electric
Tom Hobgood – NE 4-H Dev. Fund
Carolyn Smith Ivey
Vernon James
Kristina Jarrell 4-H Electric
Lorna Langley
John C. McLean
Mitchell County
North Central District 4-H Horse
North Carolina 4-H Horse Program
Denver Robinson – W 4-H Dev. Fund
Robert M. and Helen B. Runion
Gordon E. Sawyer
William E. Sawyer
IO Schaub
General Henry Hugh Shelton 4-H Leadership
Southern States Cooperative 4-H Leadership
Frank and Elizabeth Spencer
Gary Stott
Jane K. Stuart – NW 4-H Dev. Fund
Teeter Family
Rachel Kirby Thomas & Dr. Frank Bancroft Thomas 4-H Foods and Nutrition
Ray Wilkinson Communications
Robert N. Wood Collegiate 4-H
Edward H. Leagans 4-H Equine Scholarship; 1; Forsyth or NW District; $500
The William Michael Vatavuk 4- H Memorial Scholarship; 1; $500

Note to County 4-H Staff:

Please be sure to select each box the applicant is applying for on the “Online Registration Form” when submitting electronically – (Non-Restricted and Restricted!)

RESUME – Page 1

4-H Project/Activity Experience & Career Aspirations

Identify significant 4-H projects, activities, or experiences, (i.e., participation in demonstrations, talks, exhibits, workshops, judging events, media presentations, newspaper articles written, field trips, tours, and camps attended.)

1.  Title this section, “4-H Project/Activity Experience & Career Aspirations.”

2.  Career Aspirations - Explain in 2-3 sentences what your career aspirations are.

3.  Personal Information – name, address, e-mail address, phone number.

4.  4-H Project/Activity Experience:

For each project or activity include the following except career aspirations:

·  Amount of time you were involved

·  Size, scope, and diversity of project(s)

·  Extent and diversity of knowledge/skills

·  Reflection of competency

·  Extent and level of responsibilities

·  How involvement in the project or activity contributed to your personal growth

·  How you extended your knowledge/skills into your community

RESUME -- Page 2

Community Service/Citizenship/Leadership Experience

Two Sections:

1. Title the first section “4-H Community Service/Citizenship/Leadership Experience.” Provide information about your involvement in 4-H related activities.

2. Title the second section “Other Citizenship/Leadership Experience.” Provide information about other significant citizenship/leadership experiences you have had beyond your 4-H involvement. (i.e., conferences, employment, school, sports, youth, community/civic organizations).

For each activity mentioned in both the 4-H and Other Community Service/Citizenship/Leadership Experience sections provide information about:

·  The duration and extent of your involvement

·  Your role(s) and responsibilities

·  The size and scope of your effort; amount of time spent, community impact, and other resources committed

·  What you accomplished individually or as a part of a team or group

Ranking Criteria:

One-half 4-H accomplishments (Resume)

One-fourth scholastic achievement (GPA/class rank)

One-fourth college aptitude (grades/SAT or ACT scores)

Financial need is considered for some restricted scholarships

North Carolina 4-H scholarships are offered to encourage 4-H members to continue their education beyond high school. The following provisions apply to educational scholarships awarded in the North Carolina 4-H Program.

ELIGIBILITY: Current North Carolina 4-H members who are graduating high school seniors are eligible to apply. Applicants must have accumulated at least a minimum of 3 years of 4-H work. All Scholarships will be directly paid to the college or university. They will not be made payable to a 4-H’er nor his/her parents. Recipients must be full time students. Applicants must be attending College in North Carolina with the exception of the 4-H Horse Program Scholarship.

REQUIRED PARTS OF YOUR APPLICATION

_1) North Carolina 4-H Youth Scholarship Application

______2) Official high school transcript with SAT & ACT scores

3) Letters of recommendation (1 academic & 1 4-H achievement)

4) Registration form entered online by County 4-H Staff

5) Essay for Horse Applicants only – “How 4-H Has Prepared Me for the Challenges of the Future”

6) Two-page Resume as directed in the 4-H Project/Activity Experience& Career Aspirations and the Citizenship/ Leadership Experience sections of the North Carolina 4-H Application.

OPTIONAL PARTS OF YOUR APPLICATION

1) Confidential financial need letter

Do Not Add Additional pages to the Application packet

Please send in 4 copies total of your application for judging purposes!

Scholarship applications must be turned into your 4-H Agent by the county deadline. Check with your 4-H Agent for the county deadline.

FOR COUNTY 4-H STAFF ONLY

APPLICATIONS MUST BE POSTMARKED& ENTERED ONLINE BY January 15, 2008

Mail to : Shannon McCollum, Extension 4-H Associate Campus Box 7606 NCSU 512 Brickhaven Road Suite 230 Raleigh NC 27695-7606

Signature of 4-H Agent/Date Signature of 4-H’er/Date

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