Accelerated Genetics Youth Recognition Scholarship Program - 2008 Application
Applications must be submitted online or posted marked by February 15th, 2008

Contact: Kari Stanek
E10890 Penny Lane
Baraboo, WI 53913
1.800.451.9275 ext. 222
kstanek@accelgen.com

NOTE:
Read all instructions before completing.
Additional pages may be added.
DO NOT send any supplemental material (NO photos, NO transcripts, NO letters of recommendation).
If application is mailed in, DO NOT place the application in any type of binder or cover.

ELIGIBILITY:
Any high school senior who has participated in high school agriculture education, 4-H or an agricultural organization are eligible to apply. The applicant must have interest in furthering their education in an agricultural field at a short course, vocational-technical college or a four-year university degree program. Also, the applicant or their parents must be currently purchasing semen or farm products from an authorized Accelerated Genetics' representative.

AWARDS:
Four winners will be awarded a $500 scholarship.
Scholarship money will be awarded based on satisfactory (above 2.0) first semester grades.

Step 1 of 3

Personal Data

(First Name)

(Last Name)

(Applicants Phone Number)

(Home - Street Address and/or PO Box)

(Home - City)

(Home - State)

(Zip Code)

(Email Address)

(Age)

(Year In School)

(Name Of High School)

(High School - Street Address and/or PO Box)

(High School - City)

(Scholastic Ranking/Number in High School Class)

(Years of Agricultural Classes or 4-H Completed)

(Number of Members in FFA Chapter)

(Number of Members in 4-H Club)

(Parents Names)

(Accelerated Genetics' Representative)

Step 2 of 3

Farm Statistics

(if applicable, this would be your own 4-H or FFA project.)

	Livestock:
	Dairy (Milk Cows):		Dairy (Heifers & Calves):
	Dairy (Steers):		Beef (Cows & Heifers):
	Beef (Steers):		Other (Specify):

4-H & FFA Projects

(Please list your current agricultural program or projects you are involved in.)

	Projects:
	Project Name		Years
	1.
	2.
	3.
	4.
	5.

Leadership Activities

(Office and leadership positions held in all organizations, including church, school, FFA, 4-H, J.R. Breed Organizations, ect. Do not duplicate any activities.)

	Name of Organization:	Year(s):	Offices Held:
1.
2.
3.
4.
5.
6.
7.
8.

Awards & Honors

(Please list all awards and honors you have received.)

	Awards & Honors	Year(s)
1.
2.
3.
4.
5.

* If you need additional room on any of the following sections, please mail or email additional sheets. *

Step 3 of 3

Future Plans

(Briefly describe your plans for the future including education and career goals. Share some of the experiences that have encouraged you to enter into an agricultural field.)

Your Viewpoint

(If you could change any aspect of the agricultural industry, what would it be and why?)

Confirmation

I hereby certify that the information contained in this application is true and correct to the best of my knowledge.

I Agree

Complete

The license has been accepted.

Click the file application button to send in your application.