LSU AgCenter



TO:Senior High School Louisiana 4-H MembersLSU AgCenter Agents assisting 4-H Members with Scholarship ApplicationsSUBJECT:2019 Louisiana 4-H Scholarship Application and Instructions Attached is the 2019 Louisiana 4-H Scholarship Application. Please make sure that you read through the application and the requirements as the application and process has changed for 2019. DEADLINES AND DATES:Parish Deadline:Each parish will establish their own scholarship application deadline. 4-H members must check with Parish office/agent to know when deadline is.State Deadline:All applications must be received in the Louisiana 4-H Foundation Office, 104 J Norman Efferson Hall, Baton Rouge, LA 70803 by the close of business (4:30 pm) on Friday, March 8, 2019 (this is NOT postmarked, but received). ABSOULTELY NO LATE APPLICATIONS WILL BE ACCEPTED!State Judging:Scholarship application judging will take place in mid-MarchAward Notification:Scholarship winners will be notified the week of April 8-12, 2019Award Banquet:Scholarship banquet will be Tuesday, June 18, 2019 in Baton Rouge. While it is not required for scholarship winners to be present, it is highly suggested, so they may show their appreciation to their scholarship donor.SCHOLARSHIP APPLICATION SUBMISSION REQUIREMENTSApplicant must be a 2019 graduating high school senior and entering college or technical school in the Summer or Fall of 2019.Application is being submitted in printed paper form for 2019 and NOT electronically or online. Application should be submitted on white typing paper. The use of Times New Roman at a minimum of 10 point in size with black ink is required to make judging easier.4-H Scholarship application must be completed on the correct and current application to be considered.Application should only cover the past three years of the applicants 4-H career (2016-2017, 2017-2018, and 2018-2019).Application must be complete to be considered. Applicants and/or parish offices will not be contacted if application is incomplete or incorrect after it has arrived in the Louisiana 4-H Foundation Office.Applicants submitting applications for more than one scholarship need only submit a single application form.Application must be typed either using the Microsoft Word version of the application, or the application can be printed and typed using a typewriter. Handwritten applications will not be accepted.Applicants should not add additional pages to the application. Additional pages are considered “incorrect” applications and will not be considered. All necessary attachments must be submitted with the application (Transcripts with mid-term grades, ACT/SAT scores, letter of recommendation from academic advisor, teacher, guidance counselor, or principal on school letterhead. These items will not be accepted late or separate from the scholarship application.Must meet the requirements as stipulated in the scholarship criteriaApplication must contain original signatures of the school personnel, parish 4-H agent, 4-H applicant, and parent/guardian.SCHOLARSHIP PACKET REQUIREMENTSCurrent year Louisiana 4-H Scholarship Application complete, all signatures received, and typed.Transcript of grades, including mid-term grades, signed by appropriate school official.Copy of ACT/SAT scores provided by the testing agency.Letter of recommendation from academic advisor on school letterhead.PARISH INSTRUCTIONSReview application for completeness and all signatures.Ensure all required attachments are included with application.Once reviewed for correctness, go to: and complete necessary information indicating submission of application from your parish.Packet all scholarship applications from your parish in one packet and mail to the Louisiana 4-H Foundation, 104 J Norman Efferson Hall, Baton Rouge, LA 70803 so delivery in office is ensured before the close of business on Friday, March 8, 2019. NO LATE APPLICATIONS WILL BE ACCEPTED FROM PARISH OFFICES OR DIRECTLY FROM 4-H MEMBERS/FAMILIES.There is no limit for how many scholarship applications a parish may enter per scholarship. A 4-H member may enter any Louisiana scholarship they qualify for.SECTION 1: PERSONAL INFORMATIONParish in which you are a member of 4-H: FORMTEXT ?????Region in which you are a member of 4-H: FORMTEXT ?????Last Name: FORMTEXT ?????First Name: FORMTEXT ?????Middle Name (no initials): FORMTEXT ?????Nickname/Preferred Name (if applicable): FORMTEXT ?????Phonetic Spelling of Full Name: FORMTEXT ?????Gender: FORMTEXT ?????Mailing Address: FORMTEXT ?????City: FORMTEXT ?????State:LAZip: FORMTEXT ?????Home Phone Number: FORMTEXT ?????Cell Phone Number: FORMTEXT ?????Applicant’s E-mail Address: FORMTEXT ?????Date of Birth: FORMTEXT ?????Age (as of June 1, 2018): FORMTEXT ?????School grade currently enrolled in?: FORMTEXT ?????How many years have you been an enrolled 4-H member?: FORMTEXT ?????Name of Parents or Guardian(s): FORMTEXT ?????SECTION 2: SCHOLARSHIP(S) APPLYING FORCheck the scholarship(s) you are applying for: Must be a graduating senior in 2019 and entering college in the summer or fall 2019?Carl & Beulah Baldridge Memorial ($2,000)?Jason McClaran Memorial ($500, LSU-BR Ag Major)?Lyle Maier “Tinker” Bayle ($2,000, LSU-BR Agriculture Major)?Dr. & Mrs. Edward W. Gassie ($500, LSU-BR Ag Major)?Bruce Flint Memorial ($1,200)?Ruth Johnson Memorial ($500, North Louisiana Graduate)?Gloria B. Perkins ($1,000, LSU-BR Animal Science)?Gerry Lane Enterprises ($500, LSU-BR & 3.0 GPA)?Faul Family Scholarship ($1,000)?Louis Mouch ($400, West Baton Rouge 4-H member)?AP & Beryl Parham Memorial ($1,000, LSU Animal Science)?Lee Berwick Memorial ($300, Animal Science Major)?Troy A. Menard Memorial ($1,000)?Mark H. Bonner Memorial ($300)?CJ Naquin ($800, Emphasis 4-H leadership/accomplishments)?Joseph & Malvina Lamendola Memorial ($300)?Larry T. Brock Memorial ($750)?HC Sanders Memorial ($300)?Larry De La Bretonne Jr. Memorial ($600, LSU-BR Wildlife/Fisheries)?Daniel Fontenot, Jr. ($300)?Cliff Williams Memorial ($600)?Joe Walters Family ($250, 4-H Shooting Sports Member)?McCrory Family ($600, Emphasis leadership/community service)?Joe Barrett Memorial ($250, 4-H Shooting Sports Member)?American Legion ($500, Agriculture Major)?Parish Scholarship ($100, One per parish)PARISH SPECIFIC SCHOLARSHIPS?Kenneth & Mary Beatty Memorial ($1,200, Webster or Bienville with a 2.5 GPA or higher)?Beauregard Cattle Women Scholarship ($500, Beauregard, Vernon, or Allen Parish 4-H Member)?Sidney & Cecile Wood ($500, St. James 4-H Member)?Scotty Moore Memorial ($500, Bossier Parish 4-H Member?Charles Fuselier ($250, St. Martin 4-H Member)?AJ Melancon Memorial ($1,000, St. Charles Parish 4-H Member)?Holbern “Bot” Burch Memorial Scholarship ($500, Washington Parish 4-H Member)?Hilda D. & Vardaman Williams, Jr. ($500, Avoyelles, Bienville, Bossier, Caddo, Caldwell, Catahoula, LaSalle, Lincoln, Madison, Morehouse, Natchitoches, Ouachita, Rapides, Red River, Richland, Sabine, Tensas, Union, Vernon, Webster, West Carroll, or Winn 4-H Member)SECTION 3: COLLEGE/UNIVERSITY/CAREER INFORMATIONList the college/university that you plan to attend on September 1, 2019 and indicate if you have accepted, the major/course of study and the college/department the degree will be in. Include in this section your desire career choice after completion of your college career.College/University/Technical School NameAcceptedYes/NoMajor/Course of StudyDepartment in which major is offered FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Why have you chosen this field of study? FORMTEXT ?????Preferred career choice: FORMTEXT ?????SECTION 4: INDIVIDUAL SCHOLASTIC RECORDAfter the applicant has completed this section, it should be provided to their high school principal or counselor for verification and signature. Please make sure to attach transcript and testing agency report(s) to the back of the application. FORMTEXT ????? FORMTEXT ?????Name of High SchoolFunding Classification of High School (Public, Private, Home School, etc)Expected date of graduation (MM/DD/YY): FORMTEXT ?????Class ranking in graduating class: FORMTEXT ?????Number of students in graduating class: FORMTEXT ?????High school cumulative grade point average (GPA) through the mid-term. FORMTEXT ?????SATApplicant’s highest SAT score(s). Scores must be from a single test date – combining of scores is not allowed. If the applicant has not taken the SAT, leave blank.Evidence-Based Reading & WritingMathTOTAL FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????ACTApplicant’s highest ACT score(s). Scores must be from a single test date – combining of scores is not allowed. If the applicant has not taken the ACT, leave blank. FORMTEXT ?????Signature certifying validity of scholastic record is required. A copy of the applicant’s official high school transcript (ensure mid-term grades are included) and the SAT and/or ACT score(s) must be attached even though the information from these documents is included above. FORMTEXT ????? FORMTEXT ?????SignatureOfficial TitleDate FORMTEXT ????? FORMTEXT ?????SchoolTelephone Number FORMTEXT ?????Address, City, State, Zip Code FORMTEXT ?????Email AddressSECTION 5: PROJECT EXPERIENCE4-H PROJECT: List up to four (4) of your most significant 4-H projects for up to the last three (3) years. Describe years involved, knowledge and skills gained, scope and activity related to projects, demonstrations, talks, exhibits, workshops, tours, interviews, etc. Describe why these projects were important and significant and what impact your involvement provided you to have on other people. Put emphasis on the quality of your experience, rather than quantity. Please reference the level of participation/involvement as L=local/club, P=parish, R=regional, S=state, N=national, and I=international. DO NOT ADD ADDITIONAL PAGES BY EXCEEDING THE AMOUNT OF ROOM PROVIDED. FORMTEXT ?????SECTION 6: LEADERSHIP EXPERIENCE (2018-2019)4-H LEADERSHIP ROLES: List up to twenty-five (25) major 4-H leadership roles for the years indicated above. Include volunteer, promotion, and elected/appointed leadership. List roles and responsibilities, years, and levels of involvement as L=local/club, P=parish, R=regional, S=state, N=national, and I=international. Put emphasis on the quality of your experience, rather than quantity. DO NOT ADD ADDITIONAL PAGES BY EXCEEDING THE AMOUNT OF ROOM PROVIDED. DO NOT ALLOW INFORMATION TO EXTEND TO THE NEXT PAGE.YEARLEADERSHIP ROLELEVEL OF INVOLVEMENTROLE, RESPONSIBILITIES, DUTIES, AND/OR ACCOMPLISHMENTS(BRIEF STATEMENTS) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????SECTION 6: LEADERSHIP EXPERIENCE (2017-2018)4-H LEADERSHIP ROLES: List up to twenty-five (25) major 4-H leadership roles for the years indicated above. Include volunteer, promotion, and elected/appointed leadership. List roles and responsibilities, years, and levels of involvement as L=local/club, P=parish, R=regional, S=state, N=national, and I=international. Put emphasis on the quality of your experience, rather than quantity. DO NOT ADD ADDITIONAL PAGES BY EXCEEDING THE AMOUNT OF ROOM PROVIDED. DO NOT ALLOW INFORMATION TO EXTEND TO THE NEXT PAGE.YEARLEADERSHIP ROLELEVEL OF INVOLVEMENTROLE, RESPONSIBILITIES, DUTIES, AND/OR ACCOMPLISHMENTS(BRIEF STATEMENTS) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????SECTION 6: LEADERSHIP EXPERIENCE (2016-2017)4-H LEADERSHIP ROLES: List up to twenty-five (25) major 4-H leadership roles for the years indicated above. Include volunteer, promotion, and elected/appointed leadership. List roles and responsibilities, years, and levels of involvement as L=local/club, P=parish, R=regional, S=state, N=national, and I=international. Put emphasis on the quality of your experience, rather than quantity. DO NOT ADD ADDITIONAL PAGES BY EXCEEDING THE AMOUNT OF ROOM PROVIDED. DO NOT ALLOW INFORMATION TO EXTEND TO THE NEXT PAGE.YEARLEADERSHIP ROLELEVEL OF INVOLVEMENTROLE, RESPONSIBILITIES, DUTIES, AND/OR ACCOMPLISHMENTS(BRIEF STATEMENTS) FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????SECTION 7: CITIZENSHIP/COMMUNITY SERVICE EXPERIENCE4-H CITIZENSHIP AND 4-H COMMUNITY SERVICE: List up to twenty-five (25) of your citizenship and community service activities from the past three (3) years. List roles and responsibilities, years, and levels of involvement as L=local/club, P=parish, R=regional, S=state, N=national Describe why your citizenship and community service was important in these activities and what impact your involvement provided you to have on other people. Put emphasis on the quality of your experience, rather than quantity. DO NOT ALLOW INFORMATION CHARTS TO EXTEND TO THE NEXT PAGE.YEARACTIVITYLEVEL OF ACTIVITYWHY IT WAS IMPORTANT AND/OR IMPACT OF INVOLVEMENT FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????SECTION 8: 4-H HONORS AND RECOGNITION4-H HONORS: List up to twenty (20) of your most important honors received through 4-H over the past three years. List the honor, year received, level of award (e.g. L=local, P=parish, R=regional, S=state, N=national, and I=international), and why you consider the honors listed to be the most important (i.e. how did they contribute to and provide significance toward your personal development?). Put emphasis on the quality of your experience, rather than quantity.YEARAWARDLEVEL OF AWARDWHY IS THIS AWARD IMPORTANT? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????SECTION 9: OUTSIDE 4-H EXPERIENCEOUTSIDE OF 4-H LEADERSHIP ACTIVITIES, HONORS, WORK EXPERIENCE, AND VOLUNTEER/COMMUNITY SERVICE: Describe how you spent time outside of your 4-H activities, why you devoted time to a particular activity, the impact the activity had on your personal development, and how it benefitted other people. List leadership roles outside of 4-H (include school, church, other youth groups, etc). DO NOT ADD ADDITIONAL PAGES BY EXCEEDING THE AMOUNT OF ROOM PROVIDED. DO NOT ALLOW INFORMATION TO EXTEND ONTO THE NEXT PAGE. FORMTEXT ?????SECTION 10: PERSONAL NARRATIVEPrepare a personal narrative about yourself, highlighting any important facts and information you believe the selection committee should know when considering your application. This would include such things as your history in 4-H, any personal obstacles you have overcome, the greatest thing you will take from 4-H and how it influenced you. What has 4-H done for you and how have you utilized that to impact your community and state? How 4-H will help you in the future. Do not repeat any information already contained in the application. DO NOT ADD ADDITIONAL PAGES BY EXCEEDING THE AMOUNT OF ROOM PROVIDED. DO NOT ALLOW INFORMATION TO EXTEND ON TO THE NEXT PAGE. FORMTEXT ?????SECTION 11: ACKNOWLEGEMENT OF INTEGRITY, PARTICIPATION, AND CERTIFICATIONI, the undersigned, certify that the information contained herein is complete, correct and truthfully reflects my personal, 4-H, and academic background and records. I agree that, if any information contained herein is found to be falsified in any way, my application will automatically become null and void and any awarded scholarship(s) revoked.I hereby authorize any person, firm or entity to release to the Louisiana 4-H Youth Development Foundation, or their authorized representatives, information concerning the subject matter of the statements I have made in this application, including, but not limited to, information concerning my academic record, activities, honors and awards. A copy of this authorization is agreed by the undersigned to have the same effect and force as an original. Any person, firm or entity releasing matters pursuant to this authorization is hereby absolved from any liability.Please acknowledge each of the statements below by initialing with a writing pen (no type) and then sign at bottom of page.APPLICANTPARENT/GUARDIANSTATEMENTInformation presented in this application truthfully reflects the applicant’s personal, 4-H, and academic background and records.Applicant has reviewed and acknowledges all information included in the application as a true representation of themselves.Included with this application are the following attachments that have been reviewed by applicant and parent/guardian and are correct.Official High School Transcript with mid-term grades includedOfficial SAT/ACT scores provided by the testing agency.Letter of recommendation from academic advisor on school letterhead.Signature of ApplicantDateSignature of Parent/GuardianDateSECTION 12: 4-H AGENT CERTIFICATIONI certify that: this applicant has been enrolled in the Louisiana 4-H Program for the 2018-2019 4-H year, the application is complete, and all necessary attachments are included in the packet, and I recommend the applicant and his/her application be considered for a Louisiana 4-H Scholarship. FORMTEXT ?????Signature of Parish 4-H AgentDate FORMTEXT ????? FORMTEXT ?????AddressCity/State/Zip FORMTEXT ????? FORMTEXT ?????E-mail AddressOffice Phone FORMTEXT ????? FORMTEXT ?????Parish / RegionCell Number ................
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