P.O. Box 608 – 126 N. Main St. – Marysville, Ohio 43040 – (937) 642-9618 – FAX (937) 642-7376

The Walter & Doris Herd Scholarship 2010

$2500 SCHOLARSHIP AWARD (2)

Eligibility Criteria

Eligibility criteria define which students will be eligible to apply or receive the scholarship:

  • Graduating MHS senior (Includes High Point students connected to MHS)
  • Applicants must be scheduled for enrollment in a post-secondary accredited college, university or technical school.
  • Applicant should have a demonstrated interest in agriculture
  • Per the benefactor’s directive, preference will be given to student’s not ranked in the top 10% of the class

Selection Criteria

Scholarship recipients will be chosen on the basis of the following:

  • Agricultural Connection
/
  • Community Service

  • Financial Need
  • Academic Potential
/
  • Character

APPLICANT INFORMATION

A. INSTRUCTIONS - TURN COMPLETED APPLICATION & DOCUMENTATION INTO THE MARYSVILLE HIGH SCHOOL AG. ED. DEPT. (ATTEN: BILL KECK) BY JANUARY 4, 2010

The Application must be completed in full and include the following documentation:

  1. One letter of recommendation from persons other than relatives.
  2. Transcript of high school grades including GPA. (Provided by Guidance Dept.)

B. PERSONAL DATADATE

Name in Full

LastFirstMiddle

Home Address

StreetCity

Parents/guardian

StateZip

Home Phone: email: ______Birth date: ______

# of Brothersages: # of Sistersages: How many others from your household will be attending higher education in the next year?

Are you a citizen of the United States? YesNo(If no, what country______)

C. EDUCATIONAL BACKGROUND

Date of GraduationCourse taken

Rank in classApproximate # in class

D. PROPOSED COURSE OF STUDY

What degree are you pursuing with the assistance of this scholarship?

Name and address of proposed college/educational institution

NameStreet AddressCityZip

How many years in school are required to complete the degree work you are pursuing?

If you have already begun this degree program, what year have you just completed?

Will you be a full-time or a part-time student?

Beginning date of classes ______

E. PERSONAL STATEMENT

Use this space to give additional information about your ambitions, goals, background, community service, and financial need, which would assist the committee in judging you for this scholarship. (Avoid restating information previously given on this application.)

(Note: Any additional information may be added on a supplementary sheet.)

______

______

F. SPECIAL CIRCUMSTANCES: Explain any special circumstances that support your need for this scholarship ______

G. RECORD OF EXTRA-CURRICULAR ACTIVITIES:

Include school and community activities and honors. Check in the spaces provided the school year(s) in which you participated in each activity. (Attach additional sheet if necessary)

NAME OF ACTIVITY9TH10TH11TH12THOFFICES & HONORS

______

______

______

Work experience including present employment ______

______

H. PERSONAL STATEMENT REGARDING YOUR CONNECTION TO AGRICULTURE

Use this space to discuss your personal connection to agriculture past present and future.

______

______

SIGNATURE: ______

UnionCounty Foundation – Preserving Your Footprint In Time – ServingUnionCounty since 1953.

Scholarship PacketPage 1