Missy Kempken Scholarship Fund, Inc.

Application Form

2017

This scholarship was created in memory of Missy by the Kempken family and other individuals when she died at the age of 22. She loved the fair and even after graduating from 4-H and FFA, she continued working with the swine project. She truly loved the fair family, friendships and fun at the Racine County fair.

Application Instructions

Please complete the attached application form for the Missy Kempken Scholarship Fund Inc., and have itpostmarked by May 1st, 2017. Please mail applications to 2323 Maple Road Burlington, WI 53105. Late applications will not be accepted.

The scholarship applications will be scored by a three member committee. The committee will not have any Kempken family members on it.

Two $1,000 scholarships will be awarded.

Winning entries will receive their scholarship after first grades are submitted. Students may only win the scholarship once.

Requirements

  • Must have exhibited swine at the Racine County Fair
  • Must be a high school junior or senior
  • Must plan toenroll in a post-secondary education program
  • Please type or print neatly

Any questions about the scholarship, please call: Debbie Kempken at 262-534-5438.

We look forward to receiving your application.

Sincerely,

Missy Kempken Scholarship Fund Inc. Committee

PERSONAL INFORMATION (Please Print or Type)

Name: ______

(last) (first) (middle initial)

Address: ______

(Number & Street)(City)(State)(Zip Code)

E-mail: ______Phone Number: ______

Name of High School:______

Grade______

Name of 4-H Club or FFA Chapter: ______

Number of years exhibiting swine:______

Extracurricular School Activities

ActivityLength of TimeRoles and Responsibilities

______

Community/Volunteer

ActivityLength of TimeRoles and Responsibilities

______

Sports/Employment

ActivityLength of TimeRoles and Responsibilities

______

In the space provided, tell us about how your fair experiences have influenced your life and values.

1.)Thinking of your favorite memories, why do you think youth should join the Racine County Fair?

______

______

2.)Besides the swine project, what other things have you done for the benefit of your organization?

______

______

3.)What would you suggest for improvements to the swine project to encourage members to be more involved at the fair?

______

______

4.)Describe how you think your swine project/fair experiences will influence your future.

______

______