Jefferson County Pork Producers Scholarship

JEFFERSON COUNTY PORK PRODUCERS SCHOLARSHIP

ADMINISTERED BY THE GREATER JEFFERSON COUNTY FOUNDATION

SCHOLARSHIP EMPHASIS: Pork Producer Member

This award of $300 is to be applied toward the recipient's expenses at the college, university, community college or technical school outside of Jefferson County. The Jefferson County Pork Producers Scholarship is for any student in Jefferson County whose parents or they themselves are a current pork producer member. First priority will be given to a student who plans on going into an agriculture-related field.

Please fill out the requested information as completely and accurately as possible, and return completed application to the guidance office by April 1, 2011.

Type or print legibly.

Name in full: ______Birth Date: ______

Home address: ______Telephone: ______

Social Security Number: ______

Name of parents or guardians: ______

Address: ______Telephone:______

Father's occupation:______

Mother's occupation:______

HIGH SCHOOL RECORD: G.P.A.:______CLASS RANK: ______OF______

(Attach high school transcript including test scores and class rank)

High school(s) attended: ______

List high school activities in which you have participated and any offices held.

List any special honors or recognition which you have received.

List church, community or other club activities in which you have participated, and the offices held, if any.

What are your career plans? Please write a paragraph telling why you are interested in this area.

Please write a brief description on how agriculture and its products have affected your life.

What do you feel is the most important agriculture-related issue currently facing us here in Iowa and why?

Any other statement you would like to make to help the selection committee better understand your situation as to why you feel you should be considered for this award.

Please write a paragraph telling why you are interested in this career.

Any other statement you would like to make to help the selection committee better understand your situation as to why you feel you should be considered for this award.

RECOMMENDATIONS:

Please obtain the signatures of three people who would recommend you for this award. (May be educators, pastors, community leaders, etc.)

______Phone______