Masek/Vrana FFA Service & Leadership Scholarship

Honoring Chris Masek and Sharron Vrana

Please type or print legibly in blue or black ink – Date to be received is May 16, 2017

This scholarship will provide a onetime minimum of $500 scholarship to an outstanding student representing the Flatonia FFA. This scholarship will be awarded to a student that is a member of the Flatonia FFA that has dedicated outstanding service and leadership to the Flatonia FFA. This will include but not be limited to serving as an officer, working fundraisers, community service activities, and demonstrating outstanding leadership skills. The student must enroll in a college, university, or trade school to receive the scholarship.

Full Name of Applicant:______(____) (____)

Male Female

(Check One)

Date of Birth:______Age______

Home Address:______

City:______Zip:______

Telephone number:( )

E-mail address:______

Anticipated Graduation Date:______Number in Graduating Class ______

Your Current Class Rank:______Date of Ranking: ______

Scholastic Grade Average for 4 years______On What Scale: ______

Scholastic average must be expressed either as a numerical percentage, such as 98%, or as a ratio including the scale on which it is based, such as 3.87/4.0 scale. Applications without the grade scale will not be considered. An official transcript showing the grade point average/class standing must be submitted with this application.

SAT Score:______ACT Score: ______Date of Exam(s):______

Have you applied for admission to a Texas College, University or Post Education Program?

(____)(____)

Yes No

Have you been accepted?(____)(____)

Yes No

Name of college, university or program you will attend:______

Major Field of Study:______

My Future Plans:

Have you been an active member of Flatonia/FFA for at least 2 years?(____)(____)

Yes No

Which years were you an active member of the Flatonia FFA?______

FFA Activities(attach extra pages as needed)

In the spaces below, please outline your FFA activities in which you have participated (LDE, CDE, SAE) indicating any other awards, recognition or offices held.

Community Activities

In the space below, please outline any other activities in which you participate, indicating any special recognition you might have received. Include church activities or community service.

Please list any specific reasons why you need financial assistance to attend school. Financial information provided on this application will remain confidential. For example: Do you have other brothers or sisters in college at the present time which your parents are financially helping? Are there other special family situations or financial situations that affect you being able to receive financial assistance to attend school?

Other Extracurricular Activities, Honors, Awards (attach extra pages as needed)

In the spaces below, list any offices held or awards received in high school. If a repetitive award or recognition please indicate years achieved. Example: National Honor Society – 3, 4.

Certificate of Application

I hereby certify that the statements contained in this application are true, accurate, and complete and that I presently meet all eligibility requirements set forth in the guidelines and this application.

Signature of Applicant:______Date:______

Signature of Parent or Guardian:______Date:______

Signature of AST:______Date:______

Required Attachments:

Official transcript showing grade point average, class standing, and SAT or ACT score.