David Perrin Memorial Scholarship Application Form

David Perrin was the middle son of Paul and Mary Lou Perrin and the fourth generation in the family farm. He lost his life in a tragic farm accident. David and his brothers, Michael and Gregory were active in Meadow Lee Farms Ltd. Meadow Lee Farms Ltd was a 200 cow, double ten parlour operation milking twice a day. David was a valued worker on the dairy farm. He completed many 4-H projects and was very active in the Cambridge Kiwanis Junior Dairy Calf Club and Waterloo Paintball Club.

Members of the Perrin family and their many friends in the farm community established a fund in David’s memory to benefit future 4-H members with further education and to increase awareness of farm safety.

The Perrin award committee is proud to sponsor two scholarships of $1500 to be awarded September 1 and January 1. The award committee may select a single award recipient or may select separate recipients for the spring and winter semesters.

Please complete the below application by June 1, 2024.

Eligibility Requirements

An active or former 4-H participants
Applicant is pursuing further education at a post secondary institution

Application Form

Applicant Information

Name *

First

Last

Age *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email *

Name of University or College *

Course of Study *

Please list your program name

Year of Study *

Type of Post-Secondary Study *

Degree
Diploma

Applicant Questionnaire

1. Please attach a 500-word essay on the importance of farm safety. How would you improve farm safety on a farm and reach out to the farm community for ideas and lessons on safety? *

Click or drag a file to this area to upload.

2. Describe your educational background. What is the main emphasis of your course of study and your reason for enrolment in the program? *

3. List and describe your Farm experience/Agricultural employment/Involvement in Agriculture. *

4. Explain in your own words what 4-H, JF, or other agricultural youth groups have done for you in terms of personal development, leadership, education, and career choices? *

5. Future goals: Career, involvement, etc. *

6. Other: Please explain any other interests that you may have. Include activities, group awards, other community organizations, etc. *

7. Please attach proof of enrolment in a post-secondary institution. *

Click or drag a file to this area to upload.

8. Please attach current resume. *

Click or drag a file to this area to upload.

References

Please list two references and their contact information below.

Name *

First

Last

Phone *

Email *

Name *

First

Last

Phone *

Email *