Application Deadline: May 1, 2016
Application is available on web at:
OALP Class XVIII
Application
(Please type or print neatly. Preference is to complete form electronically as it is designed for available space to adjust accordingly.)
Full Name:(First Name) / (Middle Name) / (Last Name)
Date of Birth:
(Month / Day / Year)
Home Address: / (Street)
(City) / (Zip Code)
(County)
(Phone)
(Cell Phone)
(Fax)
(email)
Business Address: / (Street)
(City) / (Zip Code)
(Phone)
(Cell Phone)
(Fax)
(email)
Marital Status: / Single
Married: / Spouse’s Name:
Children’s Names & Ages:
1.
2.
3.
4.
5.
.List all schools attended including high schools, colleges, and/or short courses:
Name of School / Attendance Dates(month and year) / Date of
Completion / Degree/Cert.
Earned
Fromto
Fromto
Fromto
Fromto
Section 1 – Present Occupation – 20 points
Please indicate what percentage of your household yearly income comes from the following:
Self-employed Production Agriculture% (Answer Part A and C)
Self-employed Agricultural-related Business% (Answer Part A and C)
Employment at an Agricultural-related Business% (Answer Part B and C)
Other (Specify:) %
Total must add up to 100%
Part A – Self-Employed – Production Agriculture or Agricultural-related Business
(One of your references must be from your banker/lender or someone familiar with the financial aspects of your operation/business.)
Number of years in Production/Business:Full Time
Part Time
Describe what you produce or what your business does.
Describe your responsibilities in the operation/business.
How did you get started in production agriculture or the agricultural business?
How has the operation/business progressed since you have been involved with it? How do you measure success? (e.g. growth in size, production, efficiency, financial stability, etc.)
What is your ownership interest in the operation/business? (If you have a business partner(s), they must submit a reference form.)
Part B –Employment in an Agricultural-related Business
(One of your references must be from your employer.)
Present Employer
Supervisor’s Name
Years worked with present employer:Full Time Part Time
What is your current position?
What are your responsibilities?
What innovative programs or activities have you started or improved upon while working for this employer?
Part C – Previous Agriculture-related Employment
Dates / Where Employed / DutiesSection 2 – Involvement Outside Occupation – 20 points
(e.g. agricultural, civic, community, governmental, political, volunteer/charity, advocacy for agriculture, public education, leadership training, etc.)
In what organizations/activities are you involved? What meetings do you attend? What leadership roles have you held? What awards or honors have you received?
In answering the next two questions, consider magazines/newsletters you receive in the mail, newspapers you read, TV programs you watch, radio programs you listen to, emails, websites, message boards, and blogs you look at on the internet, twitter feeds you follow, books you have read, meetings/conferences/conventions you attend, or any other way you receive information.
How do you obtain information regarding issues important to agriculture?
How do you obtain information regarding issues important to Oklahoma, the Nation and the World?
List three individuals (at least two who are living) you consider to be progressive, innovative agriculturalleaders. For each person, list major activities and comment on why you selected them.
Name: / Activities:Comment:
Name: / Activities:
Comment:
Name: / Activities:
Comment:
Section 3 – Desire/Motivation/Commitment – 20 points
Why would you like to participate in the Oklahoma Agricultural Leadership Program?
What do you hope to obtain from the program?
What do you feel you can contribute to the program?
Participation in all the OALP sessions includes up to 55 days away from home between August 2014 and April 2016, written assignments, presentations, session evaluations, scribe note assignments, session chairperson responsibilities, and writing thank you notes. Are you prepared to invest the time and effort needed to be a successful OALP participant? Yes No
Provide any other information about yourself you think the Selection Committee should consider.
Section 4 – Questions – 20 points
In 200 words or less, please discuss what you consider to be the most important issue facing agriculture.
In 200 words or less, please discuss what you consider to be the most important issue facing your community, Oklahoma, and/or the United States.
Section 5 – References/Spouse Support – 20 points
List four referencesand ask each person to send the reference form and any additional comments directly to Edmond Bonjour prior to May 1, 2016. (If you are self-employed in production agriculture or an agricultural-related business, one reference must be from a banker/lender or someone who is familiar with the financial aspects of your farming or business practice. If you are self-employed and have a business partner(s), at least one of your partners must also submit a reference. If you are employed at an agricultural-related business, one reference must be from your employer. Additional references are your choice. Reference forms are to be sent to our office directly by the reference person (do not include with your application). For married applicants, a spouse support form must also be returned directly to the OALP office.
1. / Name: / Phone: ()Address:
2. / Name: / Phone: ()
Address:
3. / Name: / Phone: ()
Address:
4. / Name: / Phone: ()
Address:
The statements made in the application and/or statements of support are true and complete. I have read and understand the objectives of the Oklahoma Agricultural Leadership Program (which can be found at and I will participate fully in all aspects of the program. I understand that participation payments are required and that the program does not constitute college credit applicable to a degree program.
Applicant Signature:
Date:
Completed form is to be submitted by May, 1, 2016 via mail, e-mail, or Fax to:
Edmond Bonjour, Director
Oklahoma State University
Oklahoma Agricultural Leadership Program
127 Wes Watkins Center
Stillwater, OK 74078-6032
(405) 744-8134
Fax: (405) 744-9305