ALLIANCE PIPELINE SCHOLARSHIP
Administered by the Illinois Foundation FFA
1. Deadline for application is March 1. A March 1 postmark is acceptable.
2. The scholarship is available to any FFA member who is a senior at any of the 15 high schools in
the 6 Illinois counties the Alliance pipeline crosses as listed below:
Rock Island County – Rock Ridge
Whiteside County – Prophetstown
Bureau County – Bureau Valley and Princeton
LaSalle County – LaSalle-Peru, Mendota, Ottawa, Seneca, Serena and Streator Township
Grundy County – Minooka
Will County – Beecher, Lincoln-Way, Lockport and Peotone
3. Recipients may attend a two or a four year college.
4. Applicants will be judged on a combination of financial need; academic achievement; leadership;
and school, community and church involvement.
5. The scholarship selection committee will select the most qualified individuals for the
scholarships based on the selection criteria in number 4 above.
6. Five scholarships in the amount of $1,000 will be awarded annually for each of the next four years.
7. The scholarship will be paid in the fall directly to the college or university the recipients are
attending. It will be the responsibility of the scholarship recipients to provide the Illinois
Foundation FFA with:
1. Proof of enrollment at the two or four year college they are attending.
2. Information where the scholarship is to be mailed (office name and address).
3. Any necessary information such as student ID number, etc. in order for the scholarship to be credited to their student account.
8. The application and all support materials should be mailed in one envelope to the Illinois
Foundation FFA at the address above.
Application for the
ALLIANCE PIPELINE SCHOLARSHIP
(Revised 11/06/07)
PERSONAL INFORMATION:
Name: ______
Address: ______
City: ______State: ______Zip Code: ______
Date of Birth: ______
Name of High School: ______
Year in School: ______Number of Years You Have Been an FFA Member ______
My Supervised Agricultural Experience Program (SAEP) Included the Following (please list):
______
______
Your high school grade point: ______on a ______scale and class rank: ______of ______
Name of College/University you plan to attend: ______
Address: ______
City: ______State: ______Zip Code: ______
Major: ______
What do you estimate your college cost will be next year?
Tuition $______
Books/Fees $______
Room/Board $______
*Other Costs $ ______
Total Cost $______
* Ex: If living at home and commuting to school daily, cost of fuel, etc.
List FFA and school activities you have been involved in during high school.
List community and/or church activities you have been involved in.
List FFA and other leadership positions you have held in your school, community, and church.
List awards you have received (FFA, academic, extracurricular, community, church, etc.)
(2)
FAMILY INFORMATION:
Father’s name: ______Mother’s name: ______
Address: ______
City: ______State: ______Zip Code: ______
Father’s occupation: ______
Mother’s occupation: ______
How many brothers and sisters do you have? ______
Will any of them be attending a college or university next year? ______
If yes, list them by name, year in school, and name of college or university they will be attending:
FINANCIAL INFORMATION:
Parents annual income - Father: $______Mother: $______
Will you be receiving any other financial aid for school next year? ______
If yes, list the type of aid (scholarship, grant, tuition wavier, etc.) and amount:
Please give any financial information not included above which you feel the selection committee should know as they choose the scholarship recipients.
(3)
We certify that all information contained in this application is accurate and correct to the best of our knowledge.
Applicant’s signature: ______Date: ______
Parent’s signature: ______Date: ______
School official’s signature: ______Date: ______
School official’s title: (circle one) Superintendent Principal Guidance Counselor
SUPPORT MATERIALS TO BE SUBMITTED WITH YOUR APPLICATION:
2. Copy of high school transcript.
2. Three letters of reference from people other than members of your family. Two of the letters must be from school personnel. One letter must be from someone outside of school.
3. Applicant’s personal statement not to exceed one page that addresses the question “Why I
Should be Selected to Receive This Scholarship”.
Note: Applicants may attach an additional page if they need more space on page 2 of the application. Please make sure you use the headings as they appear on page 2 if you use an additional page.
(4)