Common Scholarship Application Form

Area 1 North Carolina Soil and Water Conservation District

Conservation Scholarship Application

This form is the application for Area 1 NC Soil and Water Conservation District scholarship fund. High school students interested in pursuing a college major in the studies of agriculture, field science, conservation, energy, natural resources, environmental science, or related field are encouraged to apply. Priority will be given to high school seniors, however all high school students can apply as well as students already enrolled in collegethat are from Area 1. Area 1 counties include: Buncombe, Cherokee, Clay, Graham, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, and Yancey. Specific amount of scholarship will depend on funding available that year (several scholarships in the amount of $500 are expected). Awards decision will be made before end of school year. Area 1 North Carolina SWCD committee reserves the right to call candidates in for interviews before award decision is made. Due date for application is February 10th, 2014.

Please submit application to:

Gail Heathman

589 Raccoon Road Ste. 203

Waynesville, NC28786

Or electronically at

Contact at 828-456-6341 ext. 3 with any questions

Complete the following:

Name: ______SSN (last 4 digits):______

FirstLast

Home Address ______County______Home Phone______

City______State______Zip Code______Email______

High School______School Phone______

Address______City______Zip ______

References

Provide three (3) references and list their relationship to you (teacher, employer, clergy, coach, and counselor).

Name and Relationship to youphone number

______

______

______

Applicant signature ______Date ______

ACT Composite Score______or SAT Scores: Verbal ______Math ______Writing______

Total ______

Graduation Year ______Grade Point Average ______/______Rank in Class______Class Size______(un-weighted/weighted GPA)

College Choices:Applied/AcceptedPending (date intend to apply)

First Choice______

Second Choice______

Third Choice______

Intended major(s) or interest area(s) is/are (please list in order of preference):

First choice______Second choice ______

Long Range Career Goal (ex. Wildlife technician, forestry specialist,soil scientist, etc.)______

Personal Achievements:

Please list all Soil and Water education activities you’ve participated in and what years (Envirothon, poster contest, RCW, essay contest, etc.)

YearPosition Held

______

______

______

______

______

Please list all other natural resource related activities you have participated in and what years (Girl scouts/Boy scouts, 4-H, Environmental club, internships, employment, etc.) You may attach a resume or additional sheets if necessary.

YearPosition Held

______

______

______

______

______

______

***On another sheet of paper describe what kind of career goals you would like to have in natural resources, agriculture, conservation, etc and why.