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Lewis County Farm
Bureau
2011 Scholarship
Application
Please fill out the
following Application and attach it to your "Letter of
Intention."
1.
Name:________________________________________________
2. Permanent
Address:
___________________________________________________
__________________________________________________________
3. Telephone Number (include area
code):_______________________________
4. Names of parent(s) or legal
guardian(s)________________________________
5. Address of parent(s) or legal gurardian(s):
___________________________________________________________
___________________________________________________________
6. Current High School, GED program, Trade School or College
attending:
___________________________________________________________
7. Current GPA:___________________________
8. Name and telephone number of your School Counselor:
____________________________________________________________
9. College/University/Trade School you are applying to:
____________________________________________________________
10. What is or what will your major be?
__________________________________
11. Please list any clubs, activities (agriculture, ranching or
equestrian)you are
involved
with and your
position: such as member, treasurer, secretary, etc. Please include
if
you or your family are
Farm Bureau members or if you have a ranch or family farm:
____________________________________________________________
____________________________________________________________
____________________________________________________________
_________________________
__________________
Applicant's
Signature Date
This application MUST be returned with the attched letter of
interest by April 15, 2011 to: Andrea Pinkerton, LCFB
Scholarship, 581 Boistfort Road, Curtis, WA 98538.
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