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 DateName______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 APPLICATIONA. PERSONAL INFORMATION SHEETApplication Deadline: Received in Administration Office on or before April 30, 2012Please 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 APPLICABLEName 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 STATEMENTName of Applicant ______ESTIMATED INCOME ESTIMATED EXPENSESSOURCE OF FUNDS AMOUNT USE OF FUNDS AMOUNTParents’ 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______ApplicantClark 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 APPLICATIONE. VERIFICATION LETTER FROM FAIR SUPERINTENDANT OR LEADER OR ADVISOR MUST BE RECEIVED IN THE ADMINISTRATION OFFICE ON OR BEFORE: APRIL 30, 2012Return 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 PhoneAddress ______Date______Clark County Fair Association Scholarship Application 6

SCHOLARSHIP APPLICATION Name (Please Print)

Details

Download

Copyright

We respect the copyrights and intellectual property rights of all users. All uploaded documents are either original works of the uploader or authorized works of the rightful owners.

Support