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Lewis County Farm Bureau
2010 Scholarship Application
Please fill out the following Application and attach it to
your "Letter of Intention."
1.
Name:________________________________________________
2. Permanent Address:
___________________________________________________
__________________________________________________________
3. Telephone Number (include area
code):_______________________________
4. Names of parent(s) or legal
guardian(s)________________________________
5. Address of parent(s) or legal
gurardian(s):
___________________________________________________________
___________________________________________________________
6. Current High School, GED program, Trade
School or College attending:
___________________________________________________________
7. Current GPA:___________________________
8. Name and telephone number of your
School Counselor:
____________________________________________________________
9. College/University/Trade School you are
applying to:
____________________________________________________________
10. What is or what will your major be?
__________________________________
11. Please list any clubs, activities
(agriculture, ranching or equestrian)you are
involved
with and your
position: such as member, treasurer, secretary, etc. Please include
if
you or your family are Farm Bureau members or if you have a ranch
or family farm:
____________________________________________________________
____________________________________________________________
____________________________________________________________
_________________________
__________________
Applicant's
Signature Date
This application MUST be returned with the
attched letter of interest by April 15, 2010 to: Janet Lucas, LCFB
Scholarship, 563 Middle Fork Rd, Onalaska, WA. 98570
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