/scholarship%20App.

SALINE COUNTY FARM BUREAU SCHOLARSHIP APPLICATION (Due in the Saline County Farm Bureau Office by March 31st current year) Name_________________________________ Date of Birth____________________________ Year graduated from high school (or scheduled to graduate).____________________________ Address______________________________________________________________________ City__________________________ State ____________ Zip Code _____________________ Member of 4-H?__________ If “Yes: where._________________ Parent’s Name________________________________________________________________ Parent’s Address______________________________________________________________ City__________________________ State ____________ Zip Code _____________________ Parent’s Home Phone (____) ___________ Office or Cell Phone ______________________ Number of children in family _______ in Elementary ______ Jr. High ______ Sr. High _______ College GPA for High School ______________ GPA for College (if applicable)_________________ Number in High School graduation class ___________ Rank in Graduating class _________ ACT Score ____________ And or SAT or Other ______________ List Honors received: ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Revised (1/10/2006) SALINE COUNTY FARM BUREAU SCHOLARSHIP APPLICATION

Name of College or University you plan to attend______________________________________ * Must be within the borders of the Sate of Arkansas Location of the college/university___________________________________________________ State major you plan to pursue._____________________________________________________ Will you enroll in the FALL or SPRING (Circle one)?

Current Classification _____ High School Senior _____ College Freshman _____ College Sophomore _____ College Junior _____ College Senior Are Parents members of Saline County Farm Bureau? ______ Yes ______ No If yes, how many years _________ Farm Bureau Member Number____________________ List School Activities____________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ List community and volunteer activities _____________________________________________ _____________________________________________________________________________ Do you plan to work in college? ____ Yes ____ NO.

Do you own an auto? ____ Yes ____ No

Will you take it to college? ____ Yes ____ No. Will you live on campus or commute_________?

Are you married? ____ Yes ____ No.

If yes, do you have any children?______________

Will you be enrolled for at least 12 college hours per semester? ____Yes _____No.

Signature_________________________________________ Date________________________