Stearns County Scholarship - Minnesota Corn Growers Association

STEARNS COUNTY CORN GROWERS
SCHOLARSHIP APPLICATION FORM
Intended for Members or Dependent Children of Members

Name

First Last

Scholarship Mailing Address*

Street Address Address Line 2 City State ZIP Code

Permanent Mailing Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Mobile Phone

Email*

Date of Birth*

Birth Place

How did you hear about the scholarship?

Scholastic Records

High School Name*

High School Address*

City State

High School GPA*

High School Graduation Date*

High School Rank

Have you applied for admission to college?*

Current College/University

Current College/University Address

City State

Major Field of Study

Present Academic Standing

Anticipated Completion Date of the Current Study Program

How does this field relate to agriculture?*

Briefly list your extracurricular activities in high school and/or college*

Briefly list your involvement in civic organizations in high school and/or college*

Work Experience*

Please list your jobs (including summer employment) you have held in the past three years

Job	Employer	Approximate Dates of Employment	Approximate number of hours per week

Describe your understanding of Minnesota Corn Growers Association’s role in benefiting agriculture and our communities:*

Letters of Reference*

Please provide one letter of reference that recognize the applicant's personal, academic or leadership character.

Drop files here or

Accepted file types: pdf, doc, docx, Max. file size: 2 GB, Max. files: 3.

Signature of Applicant, Guardian and School Counselor*

We certify that all information given on the application is true, correct and complete. We understand that this scholarship is to be used for tuition, fees or room and board. We understand that the scholars must enroll, and remain in good standing, in an agriculture-related degree program.

Type Applicant name here as a substitute for your signature*

Type Parent(s) or Guardian(s) name here as a substitute for signature*

Type High School Counselor or College Advisor name here as a substitute for signature*