Tulare DHIA Scholarship Application
Please print or type this application using only the space allotted for each response (no attachments other than your photograph). All questions must be answered. Please attach a recent photograph of yourself to the application. Applications must be sent to Tulare DHIA, 800 Commercial Ave., Tulare, CA 93274, postmarked no later than December 31, 2015 or delivered to the office by December 31, 2015.
Applicants name______Date of Birth______
Address______City______State_____Zip______
Phone Number______High School______
Parent's name______
Parent's Occupation______
School you plan to attend______
( ) Trade ( ) 2 year ( ) 4 year
Selected Major program______
( )Freshman ( )Continuing student
H. S. Class Rank___of___ H. S. GPA____ College GPA____ ACT or SAT Score____
1. List school activities, leadership experience and other significant accomplishments.
2. List community memberships and activities.
3. List work experience.
Page 2 (Tulare DHIA Scholarship Application)
4. List scholastic honors and awards.
5. Why do you wish to pursue the major program you listed above?
6. Have you had any experience with DHIA?
7. What major skills and/or knowledge have you gained through your DHIA experience?
8. What role do you think DHIA will play in the dairy industry in the next 10 to 20 years?
9. What do you feel has been your greatest accomplishment?
Page 3 (Tulare DHIA Scholarship Application)
Please list three references from individuals not related to you
______
Name Address Phone number
______
Name Address Phone number
______
Name Address Phone number
Please answer any two of the following questions. Use only this page for your answer.
A. Why have you chosen the school you listed and how is its program consistent with your career objectives?
B. How are you planning to finance or currently financing your college education?
C. What are your current personal, educational and career goals and objectives for your future?
D. Tell about a special experience and a related activity and how it was important to you. Has this helped you become a better citizen and develop your leadership skills?
I certify that the information in this application was provide by me and is true and complete to the best of my knowledge.
______
Signature of Applicant Date