DOUG DAWSON

FFA

MEMORIAL SCHOLARSHIP FUND

  1. Applicant must be a graduating senior of Pendleton County High School.
  1. Applicant must be an active member of the Pendleton County FFA Chapter.
  1. Applicant must be applying to the following:
  • Technical School
  • 2 year/4 year bachelor degree in Agriculture
  1. The scholarship will be awarded on a combination of the following criteria:
  2. Involvement of the Pendleton County FFA Chapter
  3. Academic Achievement
  4. Extra-Curricular Activities
  5. Community Involvement
  6. Financial Need
  1. Each applicant must submit a completed application, FFA Participation Sheet, and two letters of recommendation by people other than family members.
  1. There will be two $500 scholarships. (Pending on number of applicants and money investment).
  1. The committee will choose the candidate based on the applications submitted and its decision shall be final.
  1. Priority will be given to an applicant who is an Agricultural CO-OP student of the Pendleton County High School Agricultural Program.

DOUG DAWSON

FFA

MEMORIAL SCHOLARSHIP FUND

Name of Applicant: ______

Address: ______

Phone Number: ______

High School Grade Point Average: ______

Name of School you plan to attend: ______

Your intended major: ______

Extra Curricular Activities: ______

______

______

Community Involvement:

______

______

______

RECORD OF FFA PARTICIPATION

Name: ______FFA Chapter: ______

Age: ______Date of Birth: ______

Parent’s Name: ______Address: ______

Telephone #: ______

Social Security #: ______Date FFA Membership began: ______

Home environment (check one) [ ] Farm; [ ] Rural/Non-farm; [ ] Suburban/Subdivision; [ ] Urban/City

Check type of Supervised Agriculture Experience Program (check one):

[ ] Production Entrepreneurship / [ ] Agribusiness Entrepreneurship / [ ] Agriscience
[ ] Production Placement / [ ] Agribusiness Placement / (e.g. agri-research,
Environmental and/or
natural resources)

Other SAE Involvement (check where appropriate):

Improvement Projects: / [ ] Home; / [ ] Farm; / [ ] Environmental
Supplementary Practices: / [ ] Farm; / [ ] Agribusiness; / [ ] School Laboratory
Based SAE (beyond normal hours)
FFA LEADERSHIP RECORD
Degree Advancement / Chapter Offices / Region & State Offices
Date Received / Year / Office / Year / Office / Year
Greenhand
Chapter Degree
State Degree
COMMITTEE WORK
(Include chapter, regional, state, and national committees)
Year / Committee / Chair/Secretary/Member
LEADERSHIP IN SCHOOL AND COMMUNITY ACTIVITIES OTHER THAN FFA
(List an activity only ONCE)
Year(s) / Activity/Organization / Level of Participation (Local/Regional/State/National) / Offices, Awards
Length of Service

RECORD OF PARTICIPATION IN FFA ACTIVITIES

Record your participation in local, regional, state, and national FFA activities and contests. (Examples: National or State Conventions, FFA Leadership Training Center, Kentucky State Fair, MFE Conferences, Public Speaking, Impromptu Speaking, proficiency contests, judging contests, local and regional fairs, livestock shows, FFA local and regional banquets, University FFA Field Days, etc.)

List an activity only once. List years under appropriate column and use multiple check marks under level of participation for number of years.

School
Year(s) / Activity / Level of Participation / Results, Awards, Responsibilities, Placing, or Participation
Local / Reg. / State / Nat’l

Signed: ______

FFA Member