Dawson, TX 4-H Scholarship Application

This form is for anyone who is applying for a 4-H Scholarship from the Dawson, TX 4-H.
  • For Office Use Only

  • Scholarship Deadline: July 10, 2015

  • Scholarship Turn In Date: _________________________

    For Office Use Only
  • Scholarship Accepted by (Initials Only): __________________

    For Office Use Only
  • Application Form

    Applicants start entering information at this point.
  • Date Format: MM slash DD slash YYYY
  • Family Information

  • Date Format: MM slash DD slash YYYY
  • NameAge 
  • NameAge 
  • Academic Information

  • Number in Your Graduating ClassYour Rank
  • ACT ScoreSAT Score
  • Answer "yes" or "no"; you must have been accepted to a Texas college or University prior to the evaluation of this application; applications will not be considered from students who indicate they will enroll in out of state schools.

  • Name of Institution 
  • Activities, Honors, Awards

  • In the spaces below, list any offices held or awards received in high school. If a repetitive award or recognition, please indicate the years they were achieved. (For example, National Honor Society, 1,2,3,4.)
  • In the spaces below, please list any Community Service events or projects that you were involved in. This means you participated in or even just helped to coordinate.
  • In the spaced below, please list other clubs or activities in which you have participated, indicating any other awards, recognition or offices held in conjunction with them. (For example, Interscholastic League Competition, etc.)
  • In the space provided, please list any other activities in which you participate, indicating any special recognition you might have received.
  • In the space provided below, please let us know if there is anything else we should know about you that pertains to this scholarship and/or the reason that it is important to you to receive it.
  • Signature of Applicant (type in name)Date (mm/dd/yyyy) 
  • Signature of County AgentDate (mm/dd/yyyy)

  • D-2 Contest1.) 4-H Community Service Project2.) 4-H Community Service Project
  • Drop files here or
  • Note:

    Incomplete applications will not be considered. Applications become the property of the Dawson 4-H and will not be returned. NO EXCEPTIONS! The amount of the Scholarship for 2015 will be $300 each to two separate participants. The payment will be made to the recipient upon providing a copy of a paid registration receipt from the Educational Institution to the Dawson 4-H Office. Payment must be collected no later than September 12, 2015. Applications will be processed in the Dawson County Extension Office. If the applicant meets all the qualifications needed for the scholarship, then it will be forwarded for submission to 3 individuals from our Adult Leaders Group that are non-relatives to the applicants and they will make the final decision as to who gets the scholarships. If there is anything you need to attach to this application that you feel should be considered during this process, please feel free to attach the back of this application. Thank you and best wishes to you all!!





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