MASTIFF CLUB OF AMERICA
APPLICATION FOR JUNIOR HANDLERS SCHOLARSHIP PROGRAM
…………………………………………………………………………………………………..
(Please Print or Type)
1. Name______
last first middle
2. Home Address______
street city state zip code
3. Telephone (day) ______evening)______(e-mail)______
4. Date of birth______Age______
Place of Birth______Social Security Number______
5. Are you a U.S. citizen? Yes____No____ If no, of what country? ______
Are you a legal resident? ______
6. High School or Institute you currently attend______
If high school senior, please list schools applied to/accepted______
______
Date of graduation______Major/Area of Interest______
7. Have you ever been on probation, suspended or dismissed from school/college?
Yes____No____ If yes, explain (on a separate sheet)
8. Have you ever been suspended or investigated by the American Kennel Club?
Yes____No____ If yes, explain (on a separate sheet)
9. Describe your activities as a Junior Handler with the Mastiff Club of America:
______
10. Significant accomplishments in the sport of purebred dogs, including titles earned by dogs that you handled or Junior Showmanship wins:
______
______
11. Are you an AKC Junior Showmanship judge? Yes____No____
12. Did you qualify for the AKC/Eukanuba National Championship?
Yes____No____If yes, in what year(s)______
13. List other significant academic/extra curricular activities:
______
______
14. List extra curricular activities that relate to your involvement with purebred dogs, i.e., Responsible Dog Ownership Day, etc.: ______
______
15. If you have given a presentation in your school or community relating to purebred dogs, please explain: ______
16. Choose one of the topics below to write a 1-2 page (250-500 Word) essay: Submit 3 copies of Essay.
(1) How has your experience as a Junior Handler and your involvement as a Junior with MCOA effected you as an individual?
(2) What are your future plans and how will that effect your contribution to the Sport of Purebred Dog?
Submit completed application to:
Kelli DeSoto 8101 Nels Nelson Rd NW Bremerton WA 98311
DEADLINE: April 15, 2016
I certify that I have truthfully and accurately answered the above questions to the
best of my knowledge and belief, and that I understand any false or concealed
information will be grounds for rejection of my application or subsequent term-
ination of my scholarship. If additional information or documentation is requested
of me, I shall be pleased to furnish it. All scholarship funds will be paid directly
to the recipient of the MCOA Scholarship.
Signature______Date______
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