Please fill out this form to apply for the scholarship. Click here if you’d rather download a PDF of the form to fill out.

Click here to read the scholarship guidelines if you haven’t already done so.

Applications for the 2018-2019 school year are due by April 2, 2018.

  • I. Applicant Information



  • II. Family Information



  • III. Leadership Activities

    List major leadership related activities (clubs, extracurricular activities, offices held, awards, competitions, conferences/camps, etc.). One entry per line please; use the + icon to add a new line.

  • Add a new row
    10 maximum


  • IV. Community Involvement

    List involvement and achievement in major community activities or organizations that were helpful in making you more involved and a contributing individual to your community ( job(s), 4-H, FFA, Scouting, religious organization, sports, music, dance, etc.). One entry per line please; use the + icon to add a new line.

  • Add a new row
    10 maximum


  • V. Student Statement (Essay)

    In no more than 500 words, explain why the scholarship committee should select you for a scholarship. Please include why you have chosen your major field of study, financial need, and career plans following graduation, along with any other information you wish to share with the scholarship committee.Please attach your file in either Word or PDF format.

  • Accepted file types: docx, doc, pdf.


  • VI. Academic Information

    High school and/or college transcripts will be required if your application is selected.

    High School - please complete all information below including your high school standing and test scores.

  • Please give rank and number of students in class.
  • GPA must be on a 4.0 scale or application will be disregarded.


  • VII. Student Certification



  • VIII. Letters of Recommendation

    Please attach two signed letters of recommendation. These should be from school or community leaders that are familiar with the applicant. Please do not include recommendations from family members.

  • Accepted file types: doc, docx, pdf.
  • Accepted file types: doc, docx, pdf.
    Signed documents will be required if you are chosen for the scholarship.