RICK HUGHES MEMORIAL SCHOLARSHIP
Eligibility:Applicants must be between the ages of 17 and 19 and must have been a 4-H member for at least three years at the time of applying. 4-Hmembers who have graduated from high school are eligible to apply providing that they are in their first year of college.
Timeline:Scholarship application due date: July1, 2016
(No late applications will be accepted)
Scholarship recipients will be notified at San Bernardino County Achievement Night
Instructions for the San Bernardino County 4-H
Academic Scholarship Application Form
Information Required as Part of Your Application
To be considered as a scholarship candidate, you must include the following items in your application:
·This application form, completely filled out, with all required signatures.
·A certified copy of your high school transcript(s) and transcripts from all colleges or post-secondary schools you have attended. Transcripts must include current application year’s first semester or quarter grades.
·One letter of recommendation from a high school or college academic advisor or teacher.
·One letter of recommendation from a 4-H Youth Development Program leader in your club, special interest group, or other unit.
·One letter of recommendation from an adult not associated with the 4-H Youth Development Program from your community.
In order to ensure confidentiality, all letters of recommendation must be in a sealed envelope with the author’s signature across the flap of the envelope. Failure to follow instructions may result in your application being disqualified.
Format
If possible, use a computer or typewriter to answer the questions on this form. Otherwise, print your answers in black ink. For attachments, use plain white 8 ½" x 11" paper with
1 ½” margins at the top and left and 1" margins at the bottom and right. Write or type on one side of each sheet of paper only.
·On a typewriter, use type no smaller than 12 characters per inch (elite type). Single space within each answer and double space between questions.
·On a computer, use standard typeface such as Times in a 12-point or larger size. Single space within each answer and double space between questions.
Stay within the page limits specified for each section of the form.
Use of Information
The information submitted in this application is confidential. Demographic, academic, financial, and 4-H information will be used only by the San Bernardino County 4-H Council Selection Committee to evaluate candidates for 4-H academic scholarships and will not be released t any other individual or organization. Personal information about scholarship winners may be used in local publicity and press releases. Winners may also be asked to submit a recent photo for publicity.
San Bernardino County 4-H Scholarship Program
Purpose:1. To provide recognition to deserving older members for outstanding achievement in their 4-H careers though the award of academic scholarships.
2. To provide an incentive for older members to remain in the 4-H Program and actively contribute to the leadership and development of younger members.
3. To fill the gap created by lack of renewal of nationally funded scholarships.
Eligibility:Applicants must be between the ages of 17 and 19. Must have been a 4-H member for at least three years at the time of applying. Both current and graduated members are eligible.
Selection process:Applications are evaluated on the basis of four broad criteria, as shown on the scorecard at the end of the application form. Scholarships will be awarded to the candidates whose applications earn the highest overall scores from the judges.
Administration:A scholarship should be applied toward a course of study at an accredited college or university. However, scholarships may be applied toward a course of study at other approved educational institutions, including trade or technical schools.
Granting of Funds:Scholarship recipients must request funds through the County 4-H Council. The recipient submits to County 4-H Council a Request for Scholarship, including evidence that: (1) recipient currently is enrolled in college; and (2) the recipient plans to be enrolled in college for the following quarter or semester. If the recipient has not yet entered college, the scholarship will be held by County Council until the above requirements are met.
Forfeiture:A scholarship shall be used within one year of the date of the award.
In the event the scholarship is not used within one year’s time, the recipient must present to the County 4-H Council a request for a time extension. Failure to do so will result in forfeiture.
One-time award:A candidate will be awarded only one scholarship.
San Bernardino County
4-H Academic Scholarship Application Form
Year:______
Name (first, middle, last):______Gender:______
Name you want used in publicity:______
Home address:______Zip code:______
Home phone: (___)______SS# ______
Birthdate: ______Age as Jan. 1st this year:______
Are you currently participating in 4-H?Years in 4-H:______
Name of your 4-H club or group:______
Name and address of school you will attending on Oct. 1 of this year:
I prepared this application myself and certify that the information in it is accurate.
Date:______
Signature of 4-H Member
We have reviewed this application and believe it to be true and correct.
Date: ______
Parent Guardian signature
Date: ______
Local 4-H Leader Signature
Section A: Academic Information
1. High School:Grade Level:If not in High School, highest grade completed:
Grade point average (A=4):Class rank (check one): _____Top 10%
_____ Top 25%
Number in class: _____Top 50%
_____Other (specify)
Academic honors received:
Name and address of last high school attended and dates of attendance:
2. College or Post-Secondary School: (if none, leave blank)
Years completed:Major:
Grade point average (A=4):
Academic honors received:
Names and addresses of all colleges or post-secondary schools attended and dates of attendance:
3. National Testing Scores:
SAT: Verbal ____ Math ____Date tested:
ACT: ____Date tested:
On separate sheets of paper, answer the questions below. Limit your answer to all four questions to a total of two pages. Title each page “Section A: Academic Information” and attach the pages behind this page of the form. Remember to include your transcripts and letters of recommendation with your application (see instructions).
4. Why do you want to pursue a college or post-secondary education?
5. In what field or course of study do you plan to major or concentrate?
6. Why have you chosen this field of study?
7. How do you believe this major or concentration will help you in your future career?
On separate sheets of paper, describe your most significant 4-H projects and activities. Use up to one page per project and list no more than five projects or activities. Examples of activities include participation in demonstrations, talks, exhibits, and judging events; radio and television appearances; newspaper articles written; field trips taken; and tours, workshops, and camps attended. M Title each page “Section B: 4-H Project/Activity Experience” and attached the pages behind this page of the form.
For each project or activity, include in the description:
·The dates of the project or activity
·Why you originally chose it and what you hoped to learn from it
·The skills and types of knowledge you gained from working in it
·Whether the project or activity contributed to your personal growth and, if so how
·Whether it influenced your educational and career choices and, if so, how
On separate sheets of paper, answer the questions below. Limit your answers to both questions to a total of two pages. Title each page “Section C: Citizenship/Leadership Experience” and attach the pages behind this page of the form.
1. List in chronological order your 4-H leadership and citizenship/community service experiences. Include activities you have led or participated in that contributed to the welfare of your club or group members, other individuals outside your family, or your community, as well as major 4-H offices you have held (club, county, regional, or state).
For each activity, include in your description:
·The dates you were involved
·The role you played in the activity
·The size and scope of your efforts (time spent, people recruited, other resources committed)
·What you accomplished, alone or with others.
2. List in chronological order other significant citizenship or leadership experiences you have had outside of 4-H, in school and youth, community, or religious organizations. Include the same types of information in your descriptions of these activities as you did in your descriptions of 4-H activities in the previous question.
On separate sheets of paper, answer the questions below. Limit your answers to both questions to a total of two pages. Title each page “Section D: Career Path and Financial Information” and attach the pages behind this page of the form.
1. What career path do you plan to pursue when your education is completed? How did your experiences in 4-H influence your choice of a field of study, and your career goals?
2. How do you plan to finance your education? Be as specific as you can about costs, personal and family resources, and your anticipated need for financial assistance. List any other scholarships you have received and any educational loans or grants applied for or received.