Michigan 4-H Youth Development Scholarship Application Packet

Instructions:
The 4-H Rabbit and Cavy Scholarship is the only scholarship available through this application for 2015. The Michigan Farm and Garden Association, Inc. 4-H Scholarship is not available in 2015.
To apply for the 4-H Rabbit and Cavy Scholarship, you must:
1. Complete this application form in its entirety.
3.By November 1, 2015, submit this application form to:
Scholarships Committee
4-H Youth Development
MichiganStateUniversity
446 W Circle Drive,Morrill Hall of Agriculture
East Lansing, MI48824-1039.
This includes having your local county 4-H staff person complete the staff recommendation section on page 3. (Do not add pages except those required.) To ensure that your high school or college guidance counselorand county
4-H staff person complete their parts of the application in time, get your applications to them by mid-October.

I am applying for the (check all that apply):

 Michigan 4-H Rabbit and Cavy Scholarship

Full Name

Last First Middle

Street Address

City State Zip Code

Email Address

High School Attending in Senior Year

College You Will Attend

Number of Years in 4-H 4-H County Phone ( )

Field in which you plan to major

Grade Point Averages: High School College (if applicable)

ACT Score SAT Score (if taken) College Student ID# (if available)

List the 4-H projects you have been enrolled in and the years for each.

4-H Project / # of Years / 4-H Project / # of Years / 4-H Project / # of Years

List 4-H achievements and awards from your high school years and the years for each.

Club Level / Year / County/Regional Level / Year / State/National/
International Level / Year

List 4-H leadership involvement (club officer, committee chair, etc.) and the years for each.

Club Level / Year / County/Regional Level / Year / State/National/
International Level / Year

Describe your 4-H citizenship/community service involvement.

How has your involvement in 4-H influenced your career path and/or your choice to attend college?

Essay: How has your 4-H involvement contributed to your personal growth? (Do not add any pages.)

I declare that, to the best of my knowledge and understanding, all of the facts in this application are true.

1 Applicant’s Name

Scholarship Applicant’s Signature Date

Must be completed by county 4-H staff member:
Describe this member’s contribution and leadership to the local, county and state 4-H programs.
Signature and title Date
Printed name and title

I (name) declare that I:

Will be a college freshman in the fall of the coming year.

Have been enrolled in a 4-H rabbit/cavy project for three or more years.

The name of my 4-H club is

Received the following academic honors in high school:

•

•

•

•

•

List the 4-H Rabbit and Cavy projects, events and activities you have been involved with at the club, county and state level:

List the ways you have provided leadership and service within your 4-H Rabbit/Cavy project:

List Rabbit and Cavy related activities and experiences you have been involved with outside of 4-H:

(continue to next page)

Attached to this application is my 4-H story (maximum 3 pages of 8½- by 11-inch paper).

How will this scholarship assist you in financing your education? Include any other scholarships, loans or grants for which you have applied and special circumstances that affect your cost or need.

To be completed by a high school or college academic advisor:
Describe this individual’s academic career as it applies to this scholarship.
Signature and title Date
Printed name and title