MANSFIELD FFA CHAPTER
APPLICATION TO ATTEND THE
STATE FFA CONVENTION
Name: ______Home Campus: ______Receipt number for deposit: ______
Grade Level: 9 10 11 12 FFA Degree held: ______Age: ______Gender: M F
Home Address: ______Home Phone: ______
City: ______Zip: ______Your Phone: ______
Parent’s Name: ______Emergency Ph: ______
Years of Ag-Sci/FFA completed: ______email: ______
Number of Area FFA Conventions attended: ______List years: ______
Number of State FFA Conventions attended: ______List years: ______
Number of STATEFFA Conventions attended: ______List years: ______
Do you currently own everything needed for Official Dress? YES NO
Did you receive a failing grade in any course for the most recent grading period? YES NO
If yes, what course? ______
Give an brief overview of your SAE: ______
Give a brief overview of your SAE: ______
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List the major FFA activities that you have participated in as a member including offices held, committee service, leadership events, conventions, LDE or CDE contest and community development activities. Instead of listing activities here you may simply print out a copy of pages 3 and 4 from your SAE Record Book and attach them to this application.
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ESSAY:
Attach to this application form a short essay, not to exceed one page double-spaced, that tells why you believe that you should attend this year’s STATE FFA Convention. Be sure to focus on the skills that you can learn and share with others and how your attending the convention will benefit not only you personally but others as well (such as our chapter, school, district FFA, etc). You may include your personal FFA goals and how the convention will farther your opportunities in FFA.
OPTIONAL: Attach a copy of your resume’ to this application. (page 2 of your SAE Record Book)
Read and sign the back of this application.
STATE CONVENTION APPLICATION (pg 2)
Please carefully review each of the following items concerning the trip to the STATEFFA Convention. Your signature at the below indicates that you have read, understand, and agree to this information.
· Selection of students to attend the STATE FFA Convention is based on this application along with several other factors and is totally at the desecration of the FFA Advisors.
· Students attending the convention will be required to miss five (5) days of school. While this will count as Extra-Curricular absence (does not affect exemption status or require time to be recovered) it is the responsibility of the FFA member to make arrangement with his or her teachers regarding instruction missed and make-up work. This must be done in a timely manner.
· Members attending the convention are responsible for part of the cost involved. Expenses are divided equally among all participants. The Mansfield FFA Chapter, the Mansfield FFA Alumni Association and MISD may contribute to the overall cost, but is not guaranteed. This reduces the out of pocket expense to each individual member. The remaining cost is the responsibility of the student/parent/guardian by the time we leave for convention. Payment plans will be set in place and a calendar available in July. All money is due before departure of the trip.
· Additional money will be needed for meals not included and spending cash.
· The advisors/group coordinators make room assignments with the overall best interest of all participants in mind. This may include up to SIX students per room.
· The advisors are in charge of the group while on this trip. Any misconduct will result in disciplinary action. This could include the student being sent home (at the parent/guardians’ expense) in some cases. Members are expected to conduct themselves in a manner becoming of a member of the Mansfield FFA Chapter. Members will be expected to follow the FFA Code of Ethics and abide by any and all additional rules set forth by the advisors/group coordinators.
· Every effort is made to insure the safety of each participant. Safety records of the motor coach company are carefully reviewed. Aware of the risk incidental to said participants, I hereby waive release, indemnify, and agree to hold harmless the Mansfield Independent School District, and its officers, employees, agents, and representatives for any and all injuries incurred by my son/daughter in participation in and transporting to and/or from the FFA Ag Science activities except those injuries arising from willful misconduct on the part of said employees, agents, or representatives. In the event of accident, injury, or illness occurring in my absences necessitates medical attention, you are specially authorized and given sole discretion to obtain such medical attention, you are specially authorized and given sole discretion to obtain such medical attention at such place and from such person or persons as your sole judgment shall determine necessary and I agree to be financially responsible for the cost involved obtaining the medical attention.
· A deposit of $100 is required at the time this application is submitted. In the event that a student is not selected for the trip this amount will be refunded. For those selected to attend, payments toward the remaining balance will begin in July. The remaining cost will be collected in mid-JUNE, prior to the departure date.
· Any student who is unable to attend the Convention must inform the AST’s in writing at least 10 days prior to the departure date. Any and all funds collected toward the trip are non-refundable in this case, unless another FFA member buys the student’s share in the trip. At this time, monies will be refunded to the student not attending the trip.
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FFA Member Parent/Guardian
APPLICATION DEADLINE IS JUNE 1
Approximate expense per student for last year: $400.00 (paid by student and/or parent)
This figure is given for informational purposes only and may not reflect the actual amount for this year. This amount includes round-trip transportation, hotel for each night, convention registration, group tours and several meals. As stated above, some meals and activities are not included in this figure, nor is any “spending money” included. This amount reflects all additional funds that were used in previous years for similar trips (MISD, FFA, Alumni). The approximate total cost was $500 per student.