2014 RETURN APPLICATION BY APRIL 15

Kentucky FFA Alumni WASHINGTON LEADERSHIP CONFERENCE Scholarship

The Kentucky FFA Alumni Association provides one or more Washington Leadership Conference full and/or partial Scholarships (maximum value $550).

Eligibility

1. FFA Chapters with an active FFA Alumni Chapter will be given priority.

2. Student must be an active FFA member.

3. Agricultural Education students who are in their 9th, 10th, or 11th grades of the

current school year are eligible. Current seniors are not eligible.

4. Only one application from a chapter should be mailed.

Deadline

Applications are due postmarked by April 15.

Return To: Kentucky FFA Alumni Association c/o Kristie B Guffey 111 FFA Camp Road Hardinsburg, KY 40143-2529

Applicant's FFA Alumni Affiliate Number 16

APPLICATION

Name (Last) (First) (Middle) (S.S. Number)

Address Phone (Street/route) (City) (Zip Code) (A.C.) (No.)

FFA Chapter Birthday Age (Mo/Day/Year)

Parents Name Home Phone

Address Business Phone (Street/route) (City) (Zip Code)

Occupation of Father Mother

High School School Phone Grade In School (current year)

List Current Supervised Occupational Experience (SAE)Enterprise Scope % Candidate

Share

OrList Current Agribusiness Occupational Experience Program

Job Title or Type of Work Place of Employment Hours Worked

Brief statement of career plans after high school

Attach the Following:

1. Completed (up-to-date) official "Record of FFA Participation" activity card.

2. Brief narrative on "Why I want to further develop my leadership abilities." (No More than 300 words and in your handwriting)

Bind the material in an attractive folder. The margins should be sufficiently wide to permit reading of material.

Signed (Applicant) Signed Date (FFA Advisor) (Mo/Day/Year)