Bertram and Hazel Stewart 4-H Dairy Youth Education Award & Bursary Application Form

Application Eligibility for 4-H Ontario Participants

4-H Ontario participants who have been a 4-H Dairy Club participant for a minimum of three years (minimum one 4-H project per year) and are in good standing as a current 4-H Dairy Club participant in the year of application
Currently enrolled in grade 9, 10 or 11
Have an expressed intention to pursue post-secondary education
Are understanding of the conditional terms attached to receipt of the financial bursary

Applicant Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email *

County 4-H Association *

Name of High School *

Current Grade in School *

Applicant Questionnaire

Answer the following questions to give the selection committee an opportunity to learn more about you. Within the answers the applicant needs to demonstrate the member’s dedication, determination, and passion to 4-H, agriculture, their community and their pursuit of post-secondary education.

1. Tell us about yourself (Approx. 100 words) *

2. List your involvement in 4-H including completion of 4-H clubs and other 4-H clubs, activities, camps or conferences that you have been involved in or attended. *

3. What has been your greatest highlight of being involved in 4-H? *

4. How has your 4-H Dairy club experience shaped your ideas about agriculture and being a good advocate for agriculture? *

5. List your community/volunteer involvement and any work experience. *

6. What personal interests do you have; and at this point what are your future education plans and career/business interests? *

References

Please provide information for two references that the selection committee may contact if required.

Name of 4-H Leader *

First

Last

Club *

Phone *

Email *

Name of Other Reference *

First

Last

Phone *

Email *