Stanislaus County Hi 4-H Scholastic Scholarship

Application Due Date – March 15th, no later than 4pm (or last working day prior)

Eligibility Requirements:

*Must be a senior in high school to apply

*Must plan a post high school education program (college, trade school, work study, military, etc.)

*Hi 4-H Bylaws, Article VI, Section A, require:

1. In order to be eligible to receive a scholarship, applicant must attend 80% of all business meetings held that year.

2. Must have worked four previous fund raisers including two times in the Milk Bar (other two may also be Milk Bar in different years).

3. 4-H Autobiography (4-H story) and goals for the future – 100-400 words.

4. Two letters of recommendation (at least 1 4-H, must be unrelated to applicant).

5. Grade Point Average of at least 2.5 (include copy of transcripts)

Information Required in the Application Packet:

___ This form

___ Recommendation Letters (2)

___ Your 4-H Autobiography and Goals for the Future

___ Hi 4-H Activity Listing Pages

___ Copy of Transcripts

Name ______Current grade ______

Address ______City ______Zip ______

Phone ______Date of Birth ______

Mother’s Name ______Father’s Name ______

High School ______Counselor’s Name ______

Applicant’s Signature ______Date ______

Club Leader’s Signature ______Date ______

Date Received at 4-H Office ______Time ______Received by ______

Hi 4-H Activity Listing

Name ______

Number of years active in Hi 4-H: ______

Hi 4-H Offices Held:Year

______

______

______

Please list all involvement as a Hi 4-H member (not local club or personal activities – include this in your story)

Milk Bar (include year as an incoming Hi 4-H member)

YearManagerDay ChairWorker

______

______

______

______

Hi 4-H CommitteesMemberChairYear/How you helped

(List any that you helped plan, set up, work, clean-up, etc. List attended only on next page)

Kick Off BBQ______

Beach Camp______

San Francisco______

Snow Camp______

Pizza/Movie Night______

Scholarship______

Budget______

Other: ______

______

Fund Raiser Committees: List (do not add milk bar here – only above)

List those you helped plan, sold tickets for, worked, set/clean up, etc.

MemberChairYear(s)

Fall Dinner/Auction______

Prime Shine Sales______

Mixed Bag Sales______

E-waste______

Yard Sale______

Solicit Exchange Donations______

Other list:______

______

______

Attended the following activities:Year attended

Beach Camp/Day______

Haunted House/Barn______

San Francisco Trip______

Snow Camp______

6 Flags Trip______

Other: list type ______

______

______

Community Service Events: List those you helped with, check as member or chair

MemberChairYear

Soroptomist Tree______

Canned Food/Coat Drive______

Bell Ringing______

Cards/Letters to Military______

Scarves for homeless______

Gingerbread Houses______

Salvation Army Meal Server______

Other: list ______

______

______

Exchanges HostedTraveledYear/State

______

______

______

______

______