Ohio Grange Patrons of Husbandry Foundation

APPLICATION FOR THE

OHIO GRANGE PATRONS OF HUSBANDRY FOUNDATION

SCHOLARSHIP

Application Deadline – September 30, 2017

Section 1.Personal Information – Please Type or Print

Student’s Name ______

Student’s Date of Birth: ___/___/___

Student’s Permanent Mailing Address:

Number and Street ______

City ______Ohio Zip Code ______

Phone Number: (____) ______E-mail ______

Name of High School ______

Name of Parent(s) or Guardian(s):

Last Name ______First Name ______

Last Name ______First Name ______

Grange Affiliation (Optional): Grange Name ______Number ______

Institution where student has applied and been accepted:

Section 2.Financial Information

Parent’s IRS adjusted gross income from the previous year: $______

Any other source of income student may be receiving: $______

Explain other source(s) ______

______

Applicant’s Signature Parent or Guardian Signature

Section 3.Academic Information – To be completed by School Counselor

Student’s Highest Test Scores: Scholastic Aptitude Test – Verbal ______Math ______

American College Test - ______

The Student’s High School Rank: ______Total High School Class Size: ______

The Student’s Cumulative High School GPA (Grade Point Average on a 4.0 Scale: ______

I hereby certify that the information on this form is true and correct to the best of my knowledge for ______.

(Student’s Name)

______

(Signature of School Counselor)(Date)

APPLICATION FOR THE OHIO

GRANGE PATRONS OF HUSBANDRY FOUNDATION

SCHOLARSHIP

ESSAY

(Must be typed)

Please prepare an essay describing your high school experiences and activities. Also please include your employment record (if any and include reference name(s) with phone number and reason why you left) and future goals.

THE OHIO GRANGE PATRONS OF HUSBANDRY FOUNDATION SCHOLARSHIP FUND

Purpose:

To provide a $1,000 Scholarship to any student graduating from an Ohio High School and lives in the State of Ohio. The intent of the student is to enroll and majoring in an Agricultural related program in the State of Ohio.

Conditions:

• $1,000 per year can be given to the university or college
• No more than 2 students in any one year
• The same student may apply/receive money up to four years
• Financial need is to be considered but not mandatory
• Student must enroll in an Ohio College or University with a documented major in related Agriculture related subject
• Must include at least two (2) current letters of recommendation
• Added points for being a grange member with grange name and number
• Expect to present scholarship to recipient at the Annual Ohio State Grange Convention in October
• Payment will be made directly to the university or college, made for the benefit of the student

If there are no applications received by the deadline, the scholarship will be forwarded to the next year, with the possibility of increasing the amount of the number of eligible for the scholarship or increasing the dollar amount. That final decision will be made by the Trustees of the Ohio Grange Patrons of Husbandry Foundation.

The students receiving this money must maintain at least a 2.75 grade point average. The student must never be arrested or jailed for any crime, not to include traffic violations (like parking tickets). In order for the first time recipient to receive the 2nd, 3rd or 4th year scholarship, they must show proof of the 2.75 GPA to the Scholarship Committee before receiving the scholarship money.