University of Maine Cooperative Extension 4-H Program

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The Gladys E. Conant Memorial Farm Credit 4-H Scholarship Application

Pine Tree State 4-H Foundation

Post-Secondary Education Scholarship Application 2009

Applications must be submitted to your county 4-H staff by March 6, 2009

Name __________________________________________________________

Address _________________________________________________________

City _______________________________ State _________ Zip _________

Telephone __________________________ Email _____________________

Please include the following required materials in your scholarship application:

Please do not send any other materials than those listed below.

___ Completed 4-H Foundation scholarship application form

___ College/University transcript

___ Letter of recommendation from your past 4-H volunteer or 4-H Extension Educator or 4-H Staff Person

___ Letter from a current University Faculty

Mail your complete application to the Pine Tree State 4-H Foundation, 5741 Libby Hall, Room 103, Orono, ME 04469-5741. In order to ensure equity among applicants, incomplete applications will not be considered in the review process.

_____________________________________________________________

Signature of County 4-H Staff Date

______________________________________ __________________

Printed 4-H County Staff Name County

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