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Callahan-Shackelford County Farm Bureau
Scholarship Application
Scholarship Specifics
(4) $500 scholarships will be awarded to four recipients in the CallahanShackelford Counties school district.
� A $500 check will be made payable to the�winner’s�college�of�attendance.
� Applicants attending College, Jr. College, trade school or cosmetology
school will be accepted.
�
Eligibility Requirements
�
�
Must be a graduating High School Senior
Does NOT have to be a Farm Bureau Member
Deadline for Application
Application must be received in the Callahan-Shackelford County office
no later than May 8, 2015.
NO FAXED OR EMAILED APPLICATIONS WILL BE ACCEPTED.
Scholarship recipients will be announced no later than May 22, 2015
Applications can be mailed to
Callahan-Shackelford Co. Farm Bureau
PO Box 1175
Baird, TX 79504
Or
You may drop off the application at the Callahan-Shackelford Co. Office
441 I-20 East
Baird, TX 79504
For any questions you may have please contact Gloria Dayton at
325-854-1044 or gdayton@txfb-ins.com
CALLAHAN-SHACKELFORD COUNTY FARM BUREAU SCHOLARSHIP
APPLICATION
Application must be turned into the Callahan-Shackelford County Office no later than May 8th.
APPLICANT INFORMATION
First
Middle
Last
Name:
SSN:
E-Mail:
Street
Phone:
City
State
Zip
Current address:
FAMILY INFORMATION
Father:
Employer:
Occupation:
Mother:
Employer:
Occupation:
OTHER DEPENDENT CHILDREN
Names:
Ages:
Grade:
Names:
Ages:
Grade:
Names:
Ages:
Grade:
Names:
Ages:
Grade:
Will any siblings attend college during the same period as this applicant?
FARM BUREAU MEMBERSHIP INFORMATION (MEMBERSHIP NOT REQUIRED FOR SCHOLARSHIP)
Are you or your family a Farm Bureau
Member?
(Circle)
YES
or NO
If yes, what is
your member #
CALLAHAN-SHACKELFORD COUNTY FARM BUREAU SCHOLARSHIP
APPLICATION
High School attended:
Street
City
State
High School address:
Phone:
E-mail:
Fax:
GPA:
Graduation Date:
Applicant’s rank in Graduating Class:
Out of how many students in graduating
class?
Applicant’s highest SAT and/or ACT score
Do you have any Agriculture Leadership
Activities?
Any other Leadership activities? (Academic,
Sports, Clubs, Organizations)
List Academic honors:
COLLEGE/TRADE SCHOOL INFORMATION
College you plan to attend?
Field of Study:
Have you been accepted?
CALLAHAN-SHACKELFORD COUNTY FARM BUREAU SCHOLARSHIP
APPLICATION
Why you need Financial assistance to attend college?
What are your plans for the future?
CALLAHAN-SHACKELFORD COUNTY FARM BUREAU SCHOLARSHIP
APPLICATION
PLEASE EXPLAIN WHY YOU SHOULD BE CHOSEN FOR THIS
SCHOLARSHIP:
OPTIONAL (LETTER OF RECOMMENDATION PLEASE ATTACH)
SIGNATURE
Signature of applicant:
Date:
The recipient will receive a $500 scholarship made payable to the winner’s college of
attendance.
Applications must be received in the Callahan-Shackelford County Office no later than May 8th .
{Faxed or emailed applications will not be accepted}
Callahan-Shackelford County Farm Bureau
PO Box 1175
Baird, TX 79504
Phone-325-854-1044