SCHOLARSHIP APPLICATION Name (Please Print)

CLARK COUNTY FAIR ASSOCIATION, INC. ______

SCHOLARSHIP APPLICATION Name (please print) 17402 NE Delfel Rd., Ridgefield, WA 98642 360-397-6180 – fax 360-397-6185 **Please make sure you are using the current year’s application as changes have been made.**

THE FOLLOWING ITEMS ARE MANDATORY TO COMPLETE SCHOLARSHIP APPLICATION ALL ITEMS MUST BE RECEIVED IN THE ADMINISTRATION OFFICE ON OR BEFORE April 30, 2012. It is the applicant’s responsibility that ALL ITEMS are received by the deadline.

A. Personal Information Sheet; B. Parent’s/Guardian’s Financial Statement, if applicable; C. Applicant income and expense statement: D. One current (no older than 12 months) letter of Recommendation – see note below regarding recommendations; E. Verification Letter from Fair Superintendent or Leader or Advisor; must be a different person than letter of recommendation (no older than 12 months). F. Transcript of High School or latest school, if applicable;

NOTE: OMISSION OF ANY OF THE ABOVE SIX ITEMS DISQUALIFIES APPLICATION!

To be eligible to apply for a Clark County Fair Association, Inc. Scholarship, applicant must have been actively involved in 4-H, FFA, or Open Class at the Clark County Fair. Dependents of the Clark County Fair Board of Directors and the dependents of the FSMG employees are eligible for the Clark County Fair Association, Inc. Scholarships.

The awarding of the Clark County Fair Association, Inc. Scholarships will be based on the following criteria:

Community Involvement 20% Scholastic Ability 30% Financial Need 10% Fair Activity 25% Future Goals and Plans 15%

From D above, one recommendation from an instructor or academic advisor where you are presently enrolled in school is required (May use enclosed form). Or, If not enrolled in school, please provide a letter of recommendation from a personal or community reference.

From E above, verification letter from Fair Superintendent, Leader or Advisor -- must be from a different person than letter of recommendation.

The information received by the Clark County Fair Association, Inc. and/or the Scholarship Committee will be held in the strictest of confidence and shall not be employed for any other purpose.

The check for scholarships awarded will be issued to the college or institution of recipient with the student’s name, following receipt of proof of enrollment and associated costs from the college or institution. The recipient is responsible for getting this information to the Finance Department of the Clark County Fair Association BEFORE any payments will be remitted to an institution.

The scholarship shall be used by the recipient to whom it is awarded and within a reasonable period of time from the date of the award. The Scholarship Committee has the right to rescind the award if not used within a reasonable period.

Signature of Applicant and of Parent/Guardian, if applicable, certifies the information herein is factual, true and correct.

______Signature of Applicant Date Signature of Parent/Guardian, if applicable Date

Name______Phone #: ______

Address______City State Zip ______If college student, ______High School G.P.A. SAT score ACT score Major College G.P.A.

School you are planning to attend/are attending ______Name of Parents, if applicable ______Address______

Clark County Fair Association Scholarship Application 1 CLARK COUNTY FAIR ASSOCIATION, INC. SCHOLARSHIP APPLICATION

A. PERSONAL INFORMATION SHEET

Application Deadline: Received in Administration Office on or before April 30, 2012

Please write a short essay to answer each of the following questions (1/2 page for each question, double spaced, font 10 or 12):

What do you intend to major in? Why?

What are your future goals?

Describe your significant community involvement.

Why do you desire this scholarship?

What does the Clark County Fair mean to you?

Name of Schools Attended Address Dates of Year (High School/College) Attendance Graduated

______

Please list your major activities, achievements, and honors that indicate scholarship and leadership, with dates (use additional sheets if necessary): SCHOOL ______

______

CLARK COUNTY FAIR

______

Have your parents been members of 4-H, FFA, or of the Clark County Fair activities? If so, please give dates and activities:

Father:______

Mother:______

Clark County Fair Association Scholarship Application 2 B. PARENT/GUARDIAN FINANCIAL STATEMENT FOR STUDENT OR MINOR, IF APPLICABLE

Name of Applicant ______

Was Applicant claimed as a tax exemption on parents’ tax return for the previous year? Yes_____ No_____

To best utilize limited resources and to distribute financial assistance in the most equitable manner, the applicant’s need must be carefully evaluated. You will greatly assist the Scholarship Committee by providing the information requested below as accurately and completely as possible.

Father: Name______Age______Occupation______

Mother: Name______Age______Occupation______

Please list below all dependent children (list applicant first), indicate amount of financial support they will receive from you for higher education during the next school year.

Name Age Name of Year in Tuition Other School School Support

______$______$______

Describe below any other financial factors pertinent to your son/daughter’s application for a Clark County Fair Association, Inc. Scholarship that you wish the Scholarship Committee to consider (e.g. extraordinary family expenses such as medical, etc.): ______

______

Additional Comments:

Name (type or print) ______Date ______

Signature______

Clark County Fair Association Scholarship Application 3 C. APPLICANT INCOME AND EXPENSE STATEMENT

Name of Applicant ______

ESTIMATED INCOME ESTIMATED EXPENSES

SOURCE OF FUNDS AMOUNT USE OF FUNDS AMOUNT

Parents’ Help $______Food $______

Summer Work $______Rent $______

Work at School $______Books $______

Spousal Help $______Tuition & Fees $______

Other Scholarships (list below) $______Clothing $______

Loans (list below) $______Incidentals $______

Other (list below) $______Time Payments (list below) $______

Relative’s Help $______Bills (list below) $______

R O T C $______Travel (list below) $______

Savings $______

Tax Refund $______

TOTAL ESTIMATED INCOME $______TOTAL ESTIMATED EXPENSES $______Use space below to explain items above: Use space below to explain items above:

TOTAL ESTIMATED INCOME $______

TOTAL ESTIMATED EXPENSES $______

AMOUNT OF NEED $______

Additional Financial Comments:______

______

SIGNED______Applicant

Clark County Fair Association Scholarship Application 4 D. LETTER OF RECOMMENDATION REPORT ON APPLICANT - SCHOLASTIC (One letter required – Must be received in the Administration Office on or before April 30, 2012)

Request one letter from personal or community reference.

Return to: Clark County Fair Association, Inc. Scholarship Committee 17402 NE Delfel Road Ridgefield, WA 98642 Fax: 360-397-6185 E-Mail: [email protected]

Name of Applicant:______

Please evaluate the above applicant on the following:

A. Integrity ______

______

B. Initiative ______

______

C. Interest in Study______

______

D. Independence of ______Thought ______

E. Leadership ______

______F. Future Promise (academic success) ______

______

G. Social Skills ______

______

We encourage additional comments in the space below and/or separate pages______

______

Name (type or print) ______Title______

Signature______Phone______

Address______Date______

Clark County Fair Association Scholarship Application 5 CLARK COUNTY FAIR ASSOCIATION, INC. SCHOLARSHIP APPLICATION

E. VERIFICATION LETTER FROM FAIR SUPERINTENDANT OR LEADER OR ADVISOR MUST BE RECEIVED IN THE ADMINISTRATION OFFICE ON OR BEFORE: APRIL 30, 2012

Return to: Clark County Fair Association, Inc. Scholarship Committee 17402 NE Delfel Road Ridgefield, WA 98642 Fax: 360-397-6185 E-Mail: [email protected]

Name of Applicant:______

Please describe this applicant’s Fair activity. If possible, please include the following characteristics: Initiative; Dependability; Preparedness; Cooperation; Self-starter; Leadership; Willingness to Perform; Attitude; Participation through Years; Punctuality; Work Ethic: Attendance; and Teamwork. Please use the space below and separate sheets if necessary.

Name (Type or Print) ______

______Signed Title Phone

Address ______Date______

Clark County Fair Association Scholarship Application 6