McLennan County Youth Activities Association

Scholarship Application

Kynadi Buzbee Memorial Scholarship/Linda Goates Memorial / Mary Green Memorial Scholarship/Knapek Scholarship

The applicant must fill in this information completely and accurately. Print or type the information. Current photograph must be included with application (please do not staple).

Name

Last First MI

Address: City Zip

Phone number Date of Birth

Email address

FAMILY INFORMATION:

Father’s Name

Father’s Occupation and Employer

Mother’s Name

Mother’s Occupation and Employer

Check the applicable blank:

( ) I live at home with both parents.

( ) I live in a single parent household with my

( ) Other: Please explain if you live with a guardian, grandparent, or

have other arrangements:

Number and ages of brothers and sisters:

Will you have any brothers and/ or sisters attending college at the same time you are attending?

Yes (If yes, how many? ) No

Please check the amount that best describes your family's annual gross income:

less than $10,000 / 50,001 to $60,000
10,001 to $20,000 / 60,001 to $70,000
20,001 to $30,000 / 70,001 to $80,000
30,001 to $40,000 / 80,001 to $90,000
40,001 to $50,000 / 90,001 to $100,000 and more

ACADEMIC INFORMATION

Have you applied for admission to a college or university?

List name(s) of institution(s) to which you have applied for admission:

Have you been accepted? yes no If so, where?

What is your planned major in college?

How do you plan to use your degree?

Have you been awarded any scholarships to date? Please list:

Class Rank at time of application Number in class

Grade point average

Member of

(Please designate name of 4-H club, FFA Chapter, or FCCLA Chapter)

EXTRACURRICULAR ACTIVITIES

In the space below, please list any clubs/activities, in which you have participated, indicating any other awards, recognition, or offices held. Applicant may attach any additional information.

List the activities/ projects you have been a part of with the McLennan County Jr. Livestock Show (include number of years) Please include any participation with the youth board including number of years involved.

WORK EXPERIENCES/ JOBS HELD


In the space below, please list or describe any jobs you have held or other work experiences. Include hours worked and tell if this job was held during summers/ school year, etc.

COMMUNITY ACTIVITIES

In the space below, please list any other activities in which you participate, indicating any special recognition you might have received. For example, church activities or community service projects that were not associated with school activities.

In one typed or hand written page please tell the committee why you are continuing your education and how the McLennan County Youth Activities Association Scholarship would assist you in your future educational plans. Attach to application.

In one or two typed/hand written page(s) please tell us what hardships/set-backs you have endured during your life that have helped to shape you into a better individual, and how receiving the any of the scholarships would allow you (or assist you) to achieve your future educational goals that otherwise might not be achievable.

Applicant’s Signature______Date ______

Parent’s Signature ______Date ______

Applications must be received by WEDNESDAY Dec. 7.

Mail to:

McLennan County Youth Activities Association

Scholarship Committee c/o Cathy Wood

PO Box 8990

Waco, Texas 76714-8990