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Completed Scholarship Due by 3/10/2023
*Student Name (First & Last Name)
*Street Address (PO Box & Apt #)
*City, State, Zip Code
*Phone Number
*Email
Parent or Legal Guardian Name(s)
I am a child of a current AgState Employee
My family & I are current customers of AgState
My family & I are current Class A Members of Agstate
*High School Name
*High School Address
Class Rank
ACT Composite
*GPA
Educational Plans
I will be a full-time student in the Fall 2023 semester
Yes
No
*College or University Name
*Major or Trade
Student Involvement
Were you actively involved in your school FFA Chapter (if applicable)
Yes
No
Please designate those years you were involved
Freshman
Sophomore
Junior
Senior
Were you actively involved in 4-H (if applicable)
Yes
No
Please designate those years you were involved
Freshman
Sophomore
Junior
Senior
Copy of Official Transcript
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(Signed & Sealed)
List of all high school activity involvement
Ex. SAE projects, fundraising efforts, chapter activities, FFA contest participation, leadership positions held in FFA Chapter, degrees earned, sports, fine arts, committees, etc.
Lis of all FFA involvement
Ex. Activity involvement showing your participation by year including but not limited to projects, fundraising efforts, contest participation, and leadership positions held.
List of other Community Service & Leadership
Ex. include community service projects and any other relevant activities by year. (High School Only)
Essay
200-500 words explaining how Agriculture has impacted your life.
Reference 1
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Delete file
Please do not upload files containing personal identifiable information (PII). This includes but is not limited to SSN, credit card number, driver's license number, or taxpayer ID.
Reference 2
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Delete file
Please do not upload files containing personal identifiable information (PII). This includes but is not limited to SSN, credit card number, driver's license number, or taxpayer ID.