Ed Meliah Memorial Scholarship

Scholarship Application Form

To be considered for these scholarships or awards, you must:

1.  Return this form with your essay no later than April 30, 2014.

2.  Include a copy of your high school transcript.

3.  Include three letters of reference.

Applicants pursuing careers in agriculture will be given priority but all applications will be considered.

Senior grades will be required for 2nd marking period or 3rd for schools with six marking periods. Make sure E-mail address and your cell phone numbers are included.

YOU MUST SUBMIT APPLICATION TO BE CONSIDERED FOR THIS SCHOLARSHIP.

Complete the following:

Name: ______SSN : (last 4 digits)- ______Gender______

First Last

Home Address ______County______Home Phone______

City______State______Zip Code______E-mail______

High School______School Phone______

Address______City______Zip ______

Graduation Year______Grade Point Average ______/______Rank in Class______Class Size______

(un-weighted/weighted GPA)

Aptitude Test:

ACT Composite Score______or SAT Scores: Verbal ______Math ______Writing______Total ______

(Please submit copy of test scores to us)

Intended major(s) or interest area(s) is/are (please list in order of preference):

First choice______Second choice ______

Long Range Career Goal______

College: List the colleges you have applied or intend to apply. (Use a separate sheet if necessary.)

Application status a – applied b – intend to apply c - accepted

First ______

Second ______

Third ______

Parent/Guardian

Mothers Name______Fathers Name ______

Personal Achievements: Use a separate sheet if necessary. You may attach a resume in lieu of I, II, III, IV, and V.

I. Extra-curricular Activities or Office Held Year Position Held

______

______

______

II.  Community Service Hours served

______

______

III.  Employment

______

______

IV.  Awards

______

______

______

V.  References: List three (3) references and their relationship to you (teacher, employer, clergy, coach, and counselor).

(Submit letters of recommendations/references with application)

______

______

______

Essay: Please write a short essay describing your background, career goals, objectives and other experiences that have contributed to your personal development and future aspirations. Use a separate sheet. Essay should not exceed 350 words.

SUBMIT COMPLETED FORM TO:

Walla Walla Farmers Co-op

Attn: Kathy Scott Phone: 509-525-6690

PO Box 928 Fax: 509-525-2128

Walla Walla, WA 99362 Email:

Please return this complete application with a copy of your latest high school transcript.

Applicant signature ______Date ______

Applicants pursuing careers in agriculture will be given priority but all applications will be considered.