<p> KANSAS SEED INDUSTRY ASSOCIATION APPLICATION FOR $1,000. SCHOLARSHIP</p><p>1. Applicants may be high school seniors or college students. 2. Applicants must plan to attend a college in Kansas. 3. Applicants must be seeking a degree in Agronomy, Ag Education, Ag Econ/Business, Ag Communications, Grain/Milling Science, Ag Technology, Ag Farm Management or Horticulture.</p><p>APPLICATION DATE______(April 10 deadline) APPLICATION FOR SCHOOL YEAR ______</p><p>PERSONAL INFORMATION Full Name ______</p><p>Address ______City______St.___Zip______</p><p>Age ______Male ______Female ______</p><p>Home Phone ______Cell Phone ______</p><p>FAMILY INFORMATION Name of Parents or Guardian ______</p><p>Address if different from yours ______</p><p>Occupation of Parents ______</p><p>Do you or your family have ties to KSIA? Yes ______No ______</p><p>(If yes, please explain.) ______</p><p>List your siblings and their ages ______</p><p>______</p><p>______</p><p>Page 1 EDUCATION</p><p>Year of high school graduation ______GPA ______(based on 4.0)</p><p>Class rank ______out of ______ACT score ______</p><p>Colleges attended or currently attending (if any):</p><p>College Hours GPA Major</p><p>College you plan to attend ______</p><p>Have you been accepted? ______Planned major ______</p><p>Do you expect to receive other scholarships? Yes ______No ______</p><p>If yes, please list dollar amount you expect to receive ______</p><p>Explain briefly why you want to go to college and your choice of a major.</p><p>SCHOOL ACTIVITIES & HONORS</p><p>______</p><p>Page 2 COMMUNITY ACTIVITIES (Church, Volunteer, Scouts, 4-H etc.)</p><p>______</p><p>CAREER EXPERIENCE</p><p>List your employment experience:</p><p>Name & address of employer ______</p><p>Number of hours worked per week ______</p><p>Length of employment ______</p><p>Do you plan to work while you attend college? ______</p><p>BACKGROUND IN AGRICULTURE & SEED</p><p>Have you had any experience in agriculture or the seed industry? If so, please explain. ______</p><p>Briefly explain why you should be considered for a KSIA scholarship.</p><p>______Page 3 How did you become aware of this scholarship opportunity?</p><p>Have you applied for the KSIA scholarship in a previous year?</p><p>______</p><p>REFERENCES</p><p>Please have two people who know you and your abilities submit letters of reference along with this application.</p><p>Attach high school transcripts (college transcripts, if applicable), ACT information & reference letters and return to:</p><p>Kansas Seed Industry Assn. Roberta Donohue, Exec. Sec./Treas. 331 N. Vine St. Greeley KS 66033</p><p>Scholarship applications may be downloaded from KansasSeed.net</p><p>***Completed applications are due in our office by 5 p.m. April 10. Applications received after that date will NOT be considered. Applications may be faxed to: 785-867-2220.</p><p>Page 4</p>