Bexar County 4-H & Youth Development Program

S.A.L.E. Scholarship Application Form

SECTION 1: Personal Data

Last Name / First Name / MI / Nickname / Sex
Address / City / State / Zip
Telephone No. / E-Mail Address / # Yrs. In 4-H
Date of Birth / Age / U.S. Citizen (Y/N) / Texas Resident (Y/N)
Father’s/Guardian’s Name / Mother’s/Guardian’s Name
Texas High School From Which You Will Graduate / City in Which High School is Located

Please attach a copy of your high school transcript & SAT and/or ACT scores.

SECTION 2: San Antonio Livestock Show Participation

Exhibiting an Animal No  Yes Years Participated:

______

Judging Contests No  Yes Years Participated:

______

School Tours No  Yes Years Participated:

______

Youth Day No  Yes Years Participated:

______

Educational Presentations No  Yes Years Participated:

______

Bexar County 4-H & Youth Development Program

S.A.L.E. Scholarship Application Form

SECTION 3: College/University Career Plans

College(s)/University(s) You Plan to Attend / Have You Been Accepted?
(Yes/No)
Undergraduate Degree(s) You Plan to Pursue / Major or Minor?

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Department/College in which this Major is Offered / What is Your Preferred Career Choice?

Provide a short narrative on how you have prepared yourself to have an awareness of and understanding about the major(s) and career(s) you wish to pursue. DO NOT ADD PAGES!

Bexar County 4-H & Youth Development Program

S.A.L.E. Scholarship Application Form

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Section 4: Financial Information

Family’s Taxable Annual Income $______

Live with Both Parents(Y/N)______Live in a Single Parent Household(Y/N) ______

How many Siblings(#) ______How many Siblings in College(#) ______

I have NOT received a $20,000 Academic S.A.L.E. Scholarship
from the following entities: Texas 4-H Foundation, Texas FFA or my Local Chapter FFA Organization.

Financial Assistance:

List all the names and amounts of all scholarships/loans/grants for which you have applied and indicate if you have received confirmation.

Name of Scholarship, Loan, or Grant. / Type (Scholarship/Grant/Loan) / Total $ Value / Status (Confirmed/Pending)

Provide a short narrative of why you believe you need and should receive financial assistance in receiving this scholarship to attend the college/university of your choice. DO NOT ADD PAGES!


Bexar County 4-H & Youth Development Program

S.A.L.E. Scholarship Application Form

Section 5: Eligibility Requirements

4-H’ers who are applying for a Bexar County 4-H & Youth Development Program Scholarship are required to complete a 4-H Recordbook for the current year. The 4-H member is to verify and initial the following statements below. Then member and parent are required to sign this form (In BLUE ink please). Each 4-H member MUST meet each eligibility requirement stated here in order to be eligible for the Bexar County 4-H S.A.L.E. Scholarship.

Member
Initials / Parent
Initials / Eligibility Requirement
I, as a 4-H member, have actively enrolled and participated in 4-H sponsored events/activities during the current 4-H year (2017-2018) & at least 2 of the 3 previous years.
I have not presented any local or state FFA events/activities as 4-H & Youth Development Program events/activities or awards in my 4-H Recordbook.
The 4-H projects, leadership roles, citizenship/community service projects, honors and associated information listed in my 4-H Recordbook are a true reflection of my 4-H experiences and participation.
I have completedand submitted a 4-H Recordbook and necessary attachments for the current program year to myCounty ExtensionOffice.
I have participated in 3 different project areas to include:
______
I have participated in at least 2 community service activities to include:
______
I have participated in 3 of the following activities: (Check all that apply.)
Educational Presentation (Ex: County/State/District Roundup/Project Exhibits)
Citizenship Activities (Ex:4-H Day at the Capitol, Commissioner’s Court, Texas 4-H Congress)
Projects (6 hrs. of educational learning equates to one project completed)
Camps/Conferences (Ex: Teen Retreat, Mission Possible, District 10 4-H Conference)
Leadership Training (Ex: Leadership Lab, Texas Leadership Retreat, Officer Training,
Ambassador Program)
4-H Fundraising (Ex: Club Fundraising, Bexar County Chocolate Sales, Awards Program Silent Auction)
I have served in a 4-H leadership role. (Ex: 4-H club, county, district or state officer, youth
project leader, County Ambassador, or committee chairman/member.)
I have not received a $20,000 Academic S.A.L.E. Scholarship from the
Texas 4-H Foundation, Texas FFA Organization or Local Chapter FFA Organization.

I verify all information provided in this application to be a true reflection of my 4-H career. Any listing of inaccurate/untrue information will automatically disqualify my application.

______

4-H Member’s Signature Date

______

Parent Signature 4-H Club

______

CEA Signature

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