Applicant # Do not fill
in for committee use only.
GILLESPIECOUNTY YOUTH LIVESTOCK SHOW
SCHOLARSHIP APPLICATION FORM
COLLEGE PLANS
University, College, or Trade Schoolyou plan to attend:
MajorChosen for Your Degree:
Haveyou been accepted by the college, university or trade school indicated above?
Yes NoSAT ACT SCORE(S)
(Asindicated on the attached scholarship record)
CAREER PLANS
What is your preferred career choice?
Why have your chosen this career?
*******************************************************************************
Applicant Name______
(Last)(First) (Middle)
Female Male
Home Address ______(Street or Route) (Town) (Zip)
Telephone ______
Social Security Number Dateof Birth ______
Name of High School from which you graduated: ______
Number of years enrolled in 4-H or FFA: ______
Date: ______Signature: ______
Applicant # Do not fill in for committee use only.
RECORD OF 4-H & FFA EXPERIENCE
1.List all of your projects shown at the Gillespie County Youth Livestock Show. Describe years involved, scope and activity related to projects.
2.List major leadership roles (show most significant first); list roles and responsibilities, years, levels, duties and accomplishments.
3.4-H & FFA demonstrations, talks, exhibits and judging events. List activity, years and levels.
4.4-H or FFA citizenship activities. List activity, year and your role.
5.List your most important honors received in 4-H or FFA. List honor, year, level and number.
6.Why do you consider these honors to be the most important?
SCHOOL, CHURCH AND COMMUNITY
7.Leadership outside of 4-H or FFA (include school, church and other youth groups, etc.).
YearOffice or other roleOrganization
WHY DO YOU FEEL YOU DESERVE THIS SCHOLARSHIP?
Write or type a narrative, not more than one page in length, about yourself, pointing out any important facts you would like the committee to know. Do not repeat the information already stated in the application. Use only the blank space provided below.
2016-2017
INDIVIDUAL SCHOLASTIC RECORD FOR THE
GILLESPIECOUNTY YOUTH LIVESTOCK SHOW
SCHOLARSHIP
This record is to be completed by the applicant’s high school principal or counselor. The completed record and related materials should be returned to the applicant to become part of their scholarship application.
Expected date of graduation (MM/DD/YY):Applicant’s rank in graduation class (circle one): / Out of
Quartile ranking in graduating class (circle one): / 1st / 2nd / 3rd / 4th
High school grade point average (GPA) through the latest semester completed. MUST BE PROVIDED ON THE BASIS OF A 100 POINT UNWEIGHTED SYSTEM WITH A MAXIMUM OF 100 POINTS. (i.e. 85 or 90, NOT 3.5 or 4.0) (Extra points given for honors and AP classes should be excluded.)
Applicant’s highest SAT score(s). Scores must be from a single test date – combining of scores is not allowed. If the applicant has not taken the SAT, leave blank. / Critical Reading / Math / Writing / TOTAL
Applicant’s highest ACT score(s). Scores must be from a single test date – combining of scores is not allowed. If the applicant has not taken the ACT, leave blank.
Has the applicant passed all required standardized test(s) in order to graduate and attend a Texas college/university? / □YES / □NO
A statement of personal knowledge about this applicant is not required; however if you desire to make a statement, the selection committee will welcome any additional information you may wish to provide. Please use only the space provided on the front side of this page.
Signature certifying validity of scholastic record is required.
______
Signature Official Title Date
______
School Telephone Number
______
Address
______
E-mail Address
INSTRUCTIONS TO 4-H & FFA MEMBERS
COMPLETING THE
GILLESPIE COUNTY YOUTH LIVESTOCK SHOW
SCHOLARSHIP APPLICATION
A.WHO MAY APPLY:
Any currently enrolled 4-H or FFA members who meets the following requirements:
*Will graduate from high school during the 2016-2017 school year.
*Has taken the S.A.T. or A.C.T. test
*Has made formal application to enroll in a post secondary school (college, university or trade school)
B.MATERIALS TO BE SUBMITTED WITH THE APPLICATION:
1.The attached scholarship application form. Entries in the application must be typed or written in ink. DO NOT ADD PAGES.
2.One copy of your scholastic record completed by your high school principal or counselor. This record is to include your S.A.T. or A.C.T. score.
C.APPLICATION DUE DATES:
*Applications must be submitted to the County Extension Agents or FFA Instructors by Monday, December 1st, 2016.
Applicant# Do not fill in for committee use only.
GRADES
98-1005 points
94-974 points
90-933 points
86-892 points
81-851 point
Sub total______
SCORES
S.A.T.-Read+MathA.C.T
1400+30+5 points
1399-125026-294 points
1249-110022-253 points
1099-95018-212 points
949 & below 17 & below1 point
Sub total______
MAJOR FIELD OF STUDY
Ag Related or Trade School15 points
Other10 points
Sub total______
YEARS OF SHOW AT GILLESPIECOUNTY
3 points per year
Maximum of 36 points
Sub total______
4-H & FFA ACTIVITIES
29 points
Sub total______
OTHER ACTIVITIES
5 points
Sub total______
NEED
20 points
Sub total______
TOTAL______