Soil Conservation Society of America (Scsa)

SOIL CONSERVATION SOCIETY OF AMERICA (SCSA) Scholarship Application Form

Murray State College Foundation Tishomingo, Oklahoma 73460

This $500/year scholarship is restricted to second-year students majoring in agriculture who are interested in pursuing an education in agricultural land use. Applicant must maintain a 2.5 GPA and be enrolled full-time (12 credit hours) to receive second semester award.

INSTRUCTIONS: Please read the following information carefully and fill in all blanks.

1. Please print or type all information and attach an additional sheet if more space is required. 2. For scholarship consideration this application must be brought or mailed to: Murray State College Foundation, One Murray Campus, Tishomingo, OK 73460. 3. Deadline for receiving application materials is April 1.

The application must be complete to be considered. The scholarship will be awarded on the basis of information in the application.

(MR/MRS/MISS/MS): ______LAST NAME FIRST MI Street Address: ______City: ______State: ____ Zip: ______Phone: (____) ______Date of Application: ______SSN: ______Marital Status: __ Single; __ Married; __ Divorced. If married, is your spouse a student? ______U.S. Citizen? __ Yes __ No; Permanent U.S. Resident __ Yes __ No Name of high school: ______Number in high school class: ______High School GPA: ______College GPA: ______County: ______Year of Graduation: ______College Major: ______ACT Composite Score: ______College Address: ______Phone: (____) ______Parent/Guardian: ______LAST NAME FIRST MI Street Address: ______City: ______State: ____ Zip: ______Phone: (____) ______

D:\Docs\2018-01-08\0f3f2858e013e02575eedd5334228048.doc Revised 1-17-14 THREE REFERENCES WHO ARE NOT RELATED TO YOU:

1. (MR/MRS/MISS/MS): ______Last Name First MI Street Address: ______City: ______State: ____ Zip: ______Phone: (____) ______2. (MR/MRS/MISS/MS): ______Last Name First MI Street Address: ______City: ______State: ____ Zip: ______Phone: (____) ______3. (MR/MRS/MISS/MS): ______Last Name First MI Street Address: ______City: ______State: ____ Zip: ______Phone: (____) ______

Please attach a high school transcript and/or college transcript and the following information (TYPEWRITTEN): A. List your high school/college activities and/or offices held in organizations. B. Make a brief statement regarding your work experience. C. Make a statement regarding your financial needs. D. Provide a statement which describes your career goals.

I HEREBY CERTIFY THAT THE INFORMATION SUBMITTED IN THIS APPLICATION IS ACCURATE TO THE BEST OF MY KNOWLEDGE. I GRANT PERMISSION TO THE SCHOLARSHIP COMMITTEE MEMBERS TO REVIEW AND VERIFY CONTENTS.

______SIGNATURE OF APPLICANT

D:\Docs\2018-01-08\0f3f2858e013e02575eedd5334228048.doc Revised 1-17-14