Due: August 26th, 2016 by 4:00pm

Late or incomplete applications will not be considered for scholarships.

Citizenship Washington Focus

Scholarship Application

4-H Members must qualify for this event based on their participation during the 2015-20164-H year

4-H members must be 15 by January 1, 2017 to be considered for this award

We will award one75% registration scholarships to one 4-H members

Name______Club______T-Shirt Size:______

Address______City______Zip______Email______Phone______

Grade Completed in May 2017 ____Age (as of January 1, 17)_____

Do you have financial need for scholarship?_____

Activity / Points Possible / My Points
Record Keeping
Medal Application Completed and turned in (limit 2) / 10 points each
Record Book Completed and turned in / 50 points
Local Club Participation
Local 4-H meetings attended Number attended: ______/ 2 points each
Local club officer List office(s): ______/ 5 points
Citizenship/community service:
Circle: Individual Club Type of project: ______/ 5 points each (max 15)
County Activities and Events
Round Robin / 5 points
County Council / 5 points each
County Fair # of entries: ______/ 1 point each
County Judging Contest List: ______/ 5 points each
Communications Contest:
List: ______/ 5 points each
Food Showdown/My Favorite Foods / 5 points
Spring Livestock Show / 1 point per entry
Job Readiness Contest / 5 points
Fabrics and Fashion Contest # of entries: ______/ 2 points each
Tri-County Camp camper / 5 points
County Leadership
Ran for County Officer / 2 points
County Officer List office: ______/ 5 points
Ambassador Applicant / 2 points
County Ambassador / 5 points
Tri-County Camp Counselor / 5 points
District Activities and Events
Leadership Conference Delegate / 5 points
Share the Fun Circle: Individual Small Group Large Group / 5 points
Cloverbowl Team member / 5 points
Speech Contest:
List: ______/ 10 points each
Horse/Livestock Shows / 3 point per entry
Shooting Sports List discipline: ______/ 2 points each
Food Showdown / 5 points
Dutch Oven Showdown / 5 points
Animal Science Field Day / 2 points
FCS Skills Day / 2 points
Leadership LEAP Conference / 2 points
District Leadership
District Officer Candidate / 5 points
District Officer List office: ______/ 10 points
SED Action Team Member / 5 points
State Activities and Events
Round up Delegate / 5 points
Roundup Competitive Event List Event(s): ______/ 5 points each
State Judging Contest: List Contest(s): ______/ 5 points each
State Fair Entries: OKC: ______Tulsa: ______/ 3 points each
Oklahoma Youth Expo # of entries: ______/ 3 points each
State Horse Show / 3 points each
Shooting Sports List Discipline: ______/ 3 points each
State Leadership
State Ambassador Applicant / 5 points
State Ambassador / 10 points
State Council Applicant / 5 points
State Council Member / 10 points
Total from all pages

I certify the information on this application is accurate.

Applications without proper signatures will not be considered for scholarships

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4-H MemberDate

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Parent and/or GuardianDate