4-H Scholarship Application Cover Sheet

Attach a picture of yourself

(Staple this page to front cover of application) 4-H SCHOLARSHIP APPLICATION COVER SHEET

Name Parish: First/Middle/Last Address Email: Street/City/State/Zip

Check scholarship(s) you are applying for: Must be graduating senior in 2015 and entering college in the summer or fall 2015. Carl & Beulah Baldridge Memorial ($2,000) Jason McClaran Memorial ($500) LSU-BR College of Agriculture major Lyle Maier “Tinker” Bayle Scholarship ($2,000) Dr. & Mrs. Edward W. Gassie ($500) LSU-BR College of Agriculture LSU-BR College of Agriculture major Bruce Flint Memorial Scholarship ($1,200) Ruth Johnson Memorial ($500)

Gloria B. Perkins ($1,000) Gerry Lane Enterprises ($500) LSU-BR Animal Science Major Must attend LSU-BR and have 3.0 GPA Terril D. Faul Scholarship ($1,000) Louis Mouch ($400) West Baton Rouge 4-H Member A.P. & Beryl Parham Memorial Scholarship($1,000) Lee Berwick Memorial Scholarship ($300) Animal Science major at LSU or any of its branch campuses Animal Science major Troy A. Menard Memorial Scholarship ($1,000) Mark H. Bonner Memorial ($300) C.J. Naquin ($800) Joseph & Malvina Lamendola Memorial ($300) Emphasis on leadership roles & 4-H accomplishments Larry T. Brock Memorial ($750) H. C. Sanders Memorial ($300) Larry dela Bretonne, Jr. Memorial ($600) Daniel Fontenot, Jr. ($300) LSU/BR Wildlife/Fisheries Major Cliff Williams Memorial ($600) Joe Walters Family Scholarship ($250) Participation in 4-H Shooting Sports McCrory Family Scholarship ($600) Joe Barrett Memorial Scholarship ($250) Emphasis on leadership and community service Participation in 4-H Shooting Sports Lod Cook ($500) LA 4-H Foundation Parish Scholarship ($100) American Legion ($500) Agriculture major at a Louisiana University Parish 4-H Scholarships Kenneth anb Mary Beatty Memorial Scholarship ($1,200) Beauregard CattleWomen Scholarship ($500) Must be from Webster or Bienville Parish Must be from Beauregard, Vernon or Allen Parish Hilda D. and Vardaman Williams, Jr. Scholarship Holbern “Bot” Burch Memorial Scholarship Must be from Avoyelles, Bienville, Bossier, Caddo, Caldwell, Catahoula, Must be from Washington Parish Claiborne, Concordia, DeSoto, East Carroll, Franklin, Grant, Jackson, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Rapides, Red River, Richland, Sabine, Tensas, Union, Vernon, Webster, West Carroll or Winn Parish Sidney and Cecile Wood Scholarship Scotty Moore Memorial Scholarship Must be from St. James Parish Must be from Bossier Parish Charles Fuselier Scholarship Must be from St. Martin Parish HAVE YOU ATTACHED THE FOLLOWING? 1. Scholarship Application Form (additional pages added only where option is given). 2. Transcript of grades, including mid-term grades, signed by an appropriate official. 3. Copy of ACT scores. 4. Letter of recommendation from academic advisor on school letterhead stationery. 5. Report the past three (3) years of club work. Use one page per school year. SECTION 1 Personal / Academic Data

Name (First/Middle/Last) Yea Age Date of Birth: Month January Day r Addres s Paris City Zip h Gender Male Name of Parents or Guardians Number of Years in 4-H Name and Address of High School Class Number in Cumulative Grade Rank Class GPA Academia Honors received:

Date (attach copy of National Testing Score: ACT Tested scores) Name and address of college or school you plan to attend September 1st of this year:

In what field or course of study do you plan to major or concentrate? Why have you chosen this field of study?

I have personally prepared/reviewed this application and believe it to be correct:

Signed Date (Club Member) Signed Date (Parent or Guardian)

Signed Date (Parish Extension Agent) School Year SECTION 2 4-H Leadership List any time you taught, coordinated, organized or guided others through your 4-H work. List 4-H officer position(s) held, committees served on or other positions held. Leadership and community service develop with growth – younger members will have fewer examples.

Level Responsibility/Accomplishment(s) (L - Local, P - Parish, S - State, N - National) Example: Club demonstration – Taught 28 clubs members how to make a (L) healthy snack. Example: Served as safety chairman-school club; prepared monthly safety (L) reports and activities for eight club meetings.

Only one page per school year. School SECTION 3 Citizenship/Community Service How were you able to show your caring and citizenship qualities in 4-H this year? List 4-H activities you have participated in to help others in your community. Include hours/type of service/number of items donated, etc. Level Description of Activity (L - Local, P - Parish, R- Regional, S - State, N - National) Example: Donated 6 canned goods for Food for Families Food Drive. (L)

Only one page per school year. School Year SECTION 4 4-H Awards & Recognition List the awards, honors, recognitions you have received in 4-H, including contests, workshops, trips, etc.

Award/Recognition For What Received Example: Attendance- Certificate of Participation State 4-H Marsh Maneuvers Example: Area Commodity Ambassador Talk-Egg Certificate-Blue Ribbon

Only one page per school year. School Year SECTION 5 Non-4-H Experiences – Leadership List any time you taught, helped or guided others. List officer position(s) held, committee(s) served on or other positions held. Include only non-4-H work.

Responsibility/Accomplishment(s) Example: Youth Praise Team; Captain-Softball Team

Non–4-H Awards & Recognition Type of Award For What Received Example: Plaque-1st Place Community Beautification Poster Contest

Only one page per school year. SECTION 6 Impact Focus How did your 4-H experiences help to influence your life? What has 4-H done for you and how have you utilized that to impact your community and state? Limit your story to 3 pages typed only.

Only one page per school year. School Year

SECTION 7 Supporting Materials

1. Transcript of grades, including mid-term grades, signed by school

official.

2. Copy of ACT scores.

3. Letter of recommendation from academic advisor on school

letterhead.

4. Specific scholarship requirements, if applicable.

5. Reminder – any handwritten application will be deducted 5% of your

total score by the judges. Applicants must be a class of 2015 high school graduate: Deadline: Friday, March 6, 2015 at 4:30pm Louisiana 4-H Foundation 2015 Scholarships

Program/Donor Number of Pursue Studies In: *Scholarship Requirements Scholarships & Fall 2013 Candidate Must Be Amounts in College/University

Carl & Beulah Baldridge 4-H Foundation 1 @ $2,000 Any field of study at Entering college freshman Scholarship any accredited school or college

Lyle Maier “Tinker” Bayle Scholarship 1 @ $2,000 Any field of study at Entering college freshman LSU-BR College of Agriculture

Bruce Flint 4-H Foundation Memorial 1 @ $1,200 Any field of study at Entering college freshman Scholarship any accredited school or college

Gloria B. Perkins 4-H Foundation 1 @ $1,000 Animal Science at Entering Freshman at LSU/BR Memorial Scholarship LSU/BR majoring in Animal Science

Terril D. Faul Scholarship 1 @ $1,000 Any field of study at Entering college freshman. any accredited college Must be full-time student. or university in Louisiana

A.P. & Beryl Parham 4-H Foundation 1 @ $1,000 Animal Science at LSU Entering freshman majoring in Memorial Scholarship or any LSU branch Animal Science

Troy A. Menard Memorial Scholarship 1 @ $1,000 Any field of study at Entering college freshman. any accredited college Must be full-time student. or university in Louisiana C.J. Naquin 4-H Foundation Leadership 1 @ $800 Any field of study at Entering college freshman. Scholarship any accredited school Emphasis on 4-H leadership or college roles & accomplishments.

Larry T. Brock Memorial Scholarship 1 @ $750 Any field of study at Entering college freshman any accredited school or college

Larry De La Bretonne, Jr. 4-H Foundation 1 @ $600 Wildlife & Fisheries at Entering freshman at LSU/BR. Memorial Scholarship LSU/BR – could be one *Note: Should there not be a of 4 areas: qualified incoming freshman a. Aquaculture applicant, an upper-classman in b. Fisheries the Wildlife & Fisheries c. Fish & Wildlife Program at LSU who is a Conservation former 4-H’er majoring in d. Wildlife Aquaculture, Fisheries, Fish & Wildlife Conservation or Wildlife may apply. Cliff Williams 4-H Foundation Memorial 1 @ $600 Any field of study at Entering college freshman Scholarship any accredited school or college McCrory Family 4-H Foundation 1 @ $600 Any field of study at Entering college freshman. Scholarship LSU-BR Emphasis on 4-H leadership & community service. Lodwrick “Lod” Cook 4-H Foundation 1 @ $500 Any field of study at Entering college freshman Achievement Scholarship any accredited school or college American Legion Scholarship 1 @ $500 Agriculture at any Entering college freshman American Legion Ag. Committee college in Louisiana

Jason McClaran 4-H Foundation 1 @ $500 College of Agriculture Entering college freshman at the Memorial Scholarship at LSU College of Agriculture LSU-BR Dr. & Mrs. Edward W. Gassie 4-H 1 @ $500 LSU College of Entering college freshman at the Foundation Scholarship Agriculture including LSU College of Agriculture Human Ecology Ruth Johnson 4-H Foundation Scholarship 1 @ $500 Any field of study at Entering college freshman any accredited school or college Gerry Lane Enterprises 4-H Foundation 1 @ $500 Any field of study at Entering college freshman. Scholarship LSU/BR

Louis Mouch Memorial Scholarship 1 @ $400 Any field of study at Entering college freshman any accredited college Must be a West Baton Rouge or university in LA 4-H Member Lee Berwick 4-H Foundation Memorial 1 @ $300 Animal Science at any Entering college freshman Scholarship accredited college or *Applicants must show in the 4- school H project section significant work in the Beef and/or Horse projects Mark H. Bonner, Jr. 4-H Foundation 1 @ $300 Any field of study at Entering college freshman Achievement Scholarship any accredited school or college Joseph & Malvina Lamendola 4-H 1 @ $300 Any field of study at Entering college freshman Foundation Scholarship any accredited school or college H. C. Sanders Memorial Career 1 @ $300 Any field of study at Entering college freshman. Scholarship any accredited school Show evidence of 4-H influence or college on selection of career. Daniel Fontenot, Jr. 4-H Foundation 1 @ $300 Any field of study at Entering college freshman Scholarship any accredited school or college Joe Walters Family Scholarship 1 @ $250 Any field of study at Entering college freshman any accredited 2 or 4 Mimimum 2 years participation year school or college in 4-H Shooting Sports

Joe Barrett Memorial Scholarship 1 @ $250 Any field of study at Entering college freshman any accredited school Participation in 4-H Shooting or college Sports LA 4-H Foundation Parish Scholarships 64 @ $100 Any field of study at Entering college freshman. (1 per parish) any accredited school Award based on overall or college 4-H project work, citizenship/community service, leadership, and academic need. Other 4-H Scholarships: Program/Donor Number of Pursue Studies In: *Scholarship Requirements Scholarships & Amounts Kenneth and Mary Beatty Memorial 1 @ $1,200 Any field of study 2.5 grade point average or Scholarship enrolling as a full-time higher who have participated in undergraduate student the Webster or Bienville in any two or four Parish 4-H Program. Financial year college within the need may be a consideration. State of Louisiana. Beauregard CattleWomen Association 1 @ $500 Agriculture related Entering college freshman. Scholarship degree at any 4-year Must be full-time student. 4- institution in H’er must be from Louisiana. Beauregard, Vernon, or Allen Parish. Hilda D. Williams and Vardaman Williams, 1 @ $500 Any field of study at Selection will be based on the Jr. Scholarship any two or four year academic performance and 4-H college in the State of achievements of the eligible Louisiana. students. The recipient must be a 4-H’er from one of the following parishes: Avoyelles, Bienville, Bossier, Caddo, Caldwell, Catahoula, Claiborne, Concordia, DeSoto, East Carroll, Franklin, Grant, Jackson, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Rapides, Red River, Richland, Sabine, Tensas, Union, Vernon, Webster, West Carroll or Winn Parish. Sidney and Cecil Wood Scholarship Any field of study. The recipient must be a 4-H’er from St. James Parish. Holbern “Bot” Burch Memorial Any field of study. The recipient must be a 4-H’er Scholarship from Washington Parish. Charles Fuselier Scholarship Any field of study. The recipient must be a 4-H’er from St. Martin Parish. Scotty Moore Memorial Scholarship Any field of study. The recipient must be a 4-H’er from Bossier Parish.

NOTE: All scholarships will be awarded upon completion of the first semester by submitting a college transcript and personal thank you card addressed to the scholarship sponsor/donor to the Louisiana 4-H Foundation Office. Scholarships will be withdrawn from the recipient for any of the following reasons: being placed on disciplinary probation; or resigning and/or "dropping out" of the University.

*SCHOLARSHIP REQUIREMENTS: In addition to the requirements listed above, scholarship applicants must submit the following: 1. 4-H scholarship form must be typed. 2. Transcript of grades, including mid-term grades of senior year. 3. Copy of ACT scores. 4. One letter of recommendation from an academic advisor. 5. Any handwritten applications will be automatically deducted 5% of the total score from the judges.

Scholarship judging will take place in Baton Rouge in mid-March. Winners will be notified via their 4-H Agent by April 11, 2014. Scholarships will be judged by a committee of 4-H Agents/Volunteers representing the five Louisiana 4-H regions. Applications will be scored on leadership (30%), citizenship/community service (30%), non 4-H experiences (15%), impact focus (20%) and presentation (5%). Each application will be scored independently by each judge on the committee.