Kansas Grain and Feed Association

KANSAS GRAIN AND FEED ASSOCIATION

SCHOLARSHIPAPPLICATIONFORSCHOOL

Please type or print

PERSONAL INFORMATION

Name

(last)(first)(middle)

Address City/St/Zip

Age Home phone E-mail

Name of parents or guardian

Their address if different

Occupation of each

List brothers & sisters in college and where

Are you currently employed? Where

Number of hours worked per week Address of employer

EDUCATION

Year of high school graduation GPA (based on 4.0 scale)

Class rank out of ACT score

Colleges attending (if any)

NameHoursGPA

PLEASE ATTACH ALLHIGH SCHOOL AND COLLEGE TRANSCRIPTS TO THIS APPLICATION

College which you plan to attend

Have you been accepted? Planned major

ACTIVITIES & HONORS

Please confine all answers to the space provided. Do not use attachments.

List, in order of importance to you, extracurricular and community activities which you have participated in

(CONTNUED ON REVERSE SIDE)

Page 2 – KGFA Scholarship Application – 2004-2005 School Year

List honors and awards (not scholarships) you have received

If you have received, or will receive, scholarships indicate the name, agency granting it, and amount

FOR OUR INFORMATION

Have you had any experience in the grain and feed industry

Briefly explain why you should be considered for ne of the Kansas Grain and Feed Association scholarships (do not use

attachments)

How did you find out about this scholarship?

REFERENCES

Please ask two people who know your abilities to write in support of this application. List names, address, occupation and phone of each reference. ATTACH REFERENCES TO THIS APPLICATION.

1.

NameAddress Occupation Phone

2. .

NameAddress Occupation Phone

Please Be Sure To Attach Transcripts And References To This Completed Application & Return It To:

Kansas Grain and Feed Association, P.O. Box 2429, Topeka, KS 66601-2429 -- Attn: Shari Bennett

If Questions Call 785-234-0461 Fax: 785-234-2930 E-mail:

THIS APPLICATION IS DUE NO LATER THAN MARCH 1 NO LATE APPLICATIONS WILL BE ACCEPTED. FAXED APPLICATIONS ARE ACCEPTABLE, BUT IF YOU FAX YOUR APPLICATION DO NOT MAIL IT.