Scholarship Application
You must complete all sections of this application.
Farm Credit Services of Mandan is a premier agricultural lending and related services provider, serving the agricultural community in south central and southwestern North Dakota. Our mission is to be the first choice of rural agricultural customers and rural non-agricultural customers by promoting and providing dependable sound credit, and rural community bonds, and financial services that will meet or exceed their expectations. Selection of awardees for this scholarship is non-discriminatory and utilizes objective criteria to determine eligible candidates and awardees.
Today’s Date:Section 1: Personal Data
Name:
______
Last First Middle
School address:
______
Number and street City State Zip
Home address:
______
Number and street City State Zip
Email Address: / Home Phone: / Cell Phone:
College / University attending:
Major / Minor:
Number of Credit Hours Completed: / Current GPA:
Current Enrollment Status: □Full time □Part Time
Do you have any family members employed by Farm Credit Services of Mandan or serving on a Board of Directors for a Farm Credit system entity? □No □Yes If yes, please provide their names, position and relationship to you:
Section 2: Extracurricular Activities Related to Agriculture
Please list agriculturally related activities in which you were involved in high school or college:
Activity: (Current: □Yes □No) / Start Date / End Date / Advisor / Leader:
Please list some specific achievements you made while involved in this activity:
Activity: (Current: □Yes □No) / Start Date / End Date / Advisor / Leader:
Please list some specific achievements you made while involved in this activity:
Activity: (Current: □Yes □No) / Start Date / End Date / Advisor / Leader:
Please list some specific achievements you made while involved in this activity:
Activity: (Current: □Yes □No) / Start Date / End Date / Advisor / Leader:
Please list some specific achievements you made while involved in this activity:
Section 3: References
Please provide the names and contact information of three current or previous college instructors or advisors
Name / College / University
Position / Phone / College / University Address (street or box, city, state, zip)
Email: / Relationship and years acquainted:
Name / College / University
Position / Phone / College / University Address (street or box, city, state, zip)
Email: / Relationship and years acquainted:
Name / College / University
Position / Phone / College / University Address (street or box, city, state, zip)
Email: / Relationship and years acquainted:
Section 4: Certification
I certify that all information contained in this application is true and correct. I authorize investigation of all statements in this application. The companies and individuals named herein are authorized to give information regarding me and they are hereby released from all liability for issuing such information. I also understand that misrepresentation or omission of facts on this application or any other document used to secure scholarship money shall be grounds for rejection of this application or for immediate repayment of any monies previously awarded, regardless of the time lapsed before discovery.
I understand that neither the company’s acceptance of this application nor any actions taken as a result of that acceptance shall be construed as an offer of or contract for employment.
Submit your complete application packet containing the following by the application end date listed on careers.com:
- Completed application form;
- A written essay explaining your desire to work in the agricultural field and your career goals post-graduation;
- A current college transcript;
- Letters of reference from your three current or previous college instructors or advisors;
Human Resources Department
Box 5001
Mandan, North Dakota 58554
Signature: / Date:
Farm Credit Services of Mandan
Scholarship Application
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Version 1-18