Scholarship Application Freshman

Name(Required)

First Middle Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

High School Attended(Required)

GPA(Required)

School Planning to Attend(Required)

Address of School to Attend(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Honors Achieved(Required)

Extracurricular Activities(Required)

Community Activities (organizations, jobs, church, etc.)(Required)

Please state your career objectives and provide any information you feel might be pertinent to your eligibility for a scholarship.(Required)

Note: Applicant and/or guardian must be a member of their respective County Crop Improvement Association. Are you and/or your guardian County Crop Improvement members?(Required)

Yes

No

Applicant Name(Required)

First Last

Date(Required)

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Incoming Freshman Scholarship Application