2019 Henry and Angeline Van Poppel Scholarship App

TOLEDO COMMUNITY FOUNDATION, INC HENRY COUNTY COMMUNITY FOUNDATION Henry and Angeline Van Poppel Scholarship 2019 Information Sheet PURPOSE The purpose of the Henry and Angeline Van Poppel Scholarship is to provide post-secondary education scholarships for graduating high school seniors who are residents of Henry County, OH planning to pursue studies in the field of general agriculture or a related/closely related field – such as agribusiness, agricultural economics, agronomy, animal science, veterinary medicine, biotechnology, crop and weed sciences, etc 2018 QUALIFICATIONS FOR ELIGIBILITY Applicant must be U.S citizen; Average to above academic achievement, as demonstrated by an applicant’s GPA and college entrance test scores; and Family and/or individual income level which may preclude an applicant from receiving some financial need based grants and/or scholarship awards Recipients awarded a scholarship for their initial year of post-secondary education may apply in subsequent years for a scholarship award, provided they have maintained at least a 3.0 GPA and continue to pursue studies in the agricultural field BASIS FOR SELECTION Scholarship recipient(s) will be chosen by a special committee of the Henry County Community Foundation based on information submitted on the scholarship application form and all attachments (as noted below) HOW TO APPLY Complete scholarship application form Obtain and attach: a An official copy of your most recent transcript; b Two letters of recommendation (teachers, school administrators, employer, etc.); c A sheet listing extracurricular activities which should include school and community activities Please note offices held and any honors received d Document demonstrating your acceptance to the college or university e Essay (500 word maximum) stating how you decided upon your major and career goals after you have completed your education Submit all application materials to: Henry County Community Foundation, Inc.; ATTN: Mr Dusty Sonnenberg; 611 North Perry Street, Napoleon, OH 43545 April 1st, 2019 The above-stated criteria may be revised from time to time as deemed appropriate by the Board of Trustees of the Toledo Community Foundation, Inc., advised by the special committee of the Henry County Community Foundation TOLEDO COMMUNITY FOUNDATION, INC HENRY COUNTY COMMUNITY FOUNDATION Henry and Angeline Van Poppel Scholarship 2019 Application INSTRUCTIONS Before completing this application please review the accompanying Scholarship Information Sheet, noting the qualifications for eligibility Please print (in ink) or type all information; if an item does not apply to you, indicate N/A Mail completed application and support materials (as noted on the Scholarship Information Sheet ) to: Henry County Community Foundation; Attn: Mr Dusty Sonnenberg; 611 North Perry Street, Napoleon, OH 43545 by April 1st, 2019 Questions can be directed to Dusty Sonnenberg at (419) 966-7181 PERSONAL INFORMATION Last Name First Name _MI _ Last digits of Social Security Number XXX-XX- Gender: _ M _ F Date of Birth Permanent Address: Street _County City _State Zip Phone ( ) _ E-mail address _ Father’s Name/Guardian’s Name _ Occupation (Position) (Company) Mother’s Name/Guardian’s Name Occupation (Position) (Company) List the names and ages of all persons (excluding those above) residing at your permanent address: Name _Age Name _Age Name _Age Name _Age EDUCATION High School Graduation Date Cumulative GPA Composite Scores: ACT _ or SAT (excluding writing section) _ College, university or other school you will attend for the 2019-2020 academic year Degree you are pursuing How many years will your academic program take to complete? _ EDUCATIONAL FUNDING List any scholarships, grants, and/or other awards (for the 2019-2020 academic year) you have received as of this time Indicate if they are renewable or one-time awards: Source _Amount Renewable? Source _Amount Renewable? Source _Amount Renewable? List any scholarships, grants, and/or other awards for which you have applied (for the 2019-2020 academic year) and are awaiting a decision Please include an approximate date as to when you will be advised of a decision: Source _Amount Decision _ _ Source _Amount Decision _ _ Source _Amount Decision _ _ Do you currently have a job? _ If so where? How you plan to spend your summer break? _ List your anticipated costs for the 2019-2020 academic year: Tuition & related fees Books _Room & Board _ Do you plan to reside on campus? I hereby certify that the information provided on this application is, to the best of my knowledge, true and correct I agree, if requested, to provide the Foundation with additional information needed to determine my qualification for this scholarship If I become a scholarship recipient, and if requested by the Foundation, I agree to furnish reports that can be used to determine my academic progress and use of scholarship funds Further, I give my permission to the Henry County Community Foundation to release any pertinent information for publicity purposes Applicant’s Signature _Date _ If Applicant is Under Age 18 Parent/Guardian Signature _Date ... FOUNDATION, INC HENRY COUNTY COMMUNITY FOUNDATION Henry and Angeline Van Poppel Scholarship 2019 Application INSTRUCTIONS Before completing this application please review the accompanying Scholarship. .. Renewable? List any scholarships, grants, and/ or other awards for which you have applied (for the 2019- 2020 academic year) and are awaiting a decision Please include an approximate date as to... information; if an item does not apply to you, indicate N/A Mail completed application and support materials (as noted on the Scholarship Information Sheet ) to: Henry County Community Foundation;