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4-H Camp Scholarship Application

4-H Camp Scholarship Application

Please give as much of the following information as possible and return to:


Donna Mull, 4-H Agent

Cooperative Extension Service

PO Box 389

Newton, NC 28658.

E-mail to: donna_mull@ncsu.edu

Call 828- 465-8240 or e-mail if you have any questions. Scholarships provided by Hickory Kiwanis Club and American Legion Fair Board.

Due MARCH 15, 2019

Child’s Name__________________________________________Age______M_____F_____

Address____________________________________________________________

Phone_____________ E-mail_______________________________________________

Parents or Guardians_________________________________________________________

Mother’s place of Employment_________________________________________________

Position_______________________________________________________________

Father’s place of Employment_________________________________________________

Position________________________________________________________________

Number of  Family Members_______ Has the child attended camp before? _____yes _____no    Where and When?

Is the child/family aware they have been nominated for a camp scholarship?

Yes  No

Amount family could pay toward Camp Cost:  _____________

(Scholarship winners are asked to pay some portion toward the camp cost.)

Describe what you know of family’s financial situation:   (Attach separate page if necessary)

If this child receives a camp scholarship, who would be willing to work with the family and the 4-H program to insure that the proper paperwork is completed and that the child has transportation to and from the camp bus?

Name________________________________________________Phone____________

This information is true to be best of my knowledge:

________________________________________________Title___________________

Agency/School___________________________________________________

Address:____________________________________________Phone_____________

*All information provided will be held in confidence and will be used only in determination of scholarship recipients.

Attach the following:

  • LETTERS OF RECOMMENDATION FROM AN ADULT WHO KNOWS THE CHILD STATING WHY THE CHILD SHOULD RECEIVE A SCHOLARSHIP.

 

  • PARAGRAPH WRITTEN BY THE CHILD EXPLAINING WHY THEY WANT TO ATTEND CAMP AND WHY THEY ARE SEEKING A SCHOLARSHIP.