Tulare County Farm Bureau Scholarship Application
Deadline: March 1, annually
Must currently attend or have graduated from a school in Tulare County to be eligible.

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You will only be selected for one scholarship annually. Please select all criteria that apply below.

I will attend a 4-year university

I will attend a 2-year college

What college or university do you attend or plan to enter:
City:   Major or course of study:
Enrollment to begin:
For what occupation are you preparing:

I will major in an agricultural field of study

I will major in a non-agricultural field of study

One or both of my parents is a farm employee (and does not own or operate a farm)

I attend a school in the Visalia Unified School district

First Name:  MI:  Last Name:

Permanent Address
City:  State:  Zip:
Phone Number:

Student Address (if enrolled in college)
City:  State:  Zip:

E-mail Address:

Date of Birth: (mm/dd/yyyy)
Birthplace: (city/state)

Father's Full Name:
Father's Occupation:
Mother's Full Name:
Mother's Occupation:
School Name:
School Address:
School City:  State:  Zip:
GPA: (Required)

How did you hear about this scholarship?

List your work experience during the past four years. Indicate dates of employment in each job and approximate number of hours worked each week. List the total amount earned at each job.

PositionDate from (mo/yr)Date to (mo/yr)Hours per weekTotal amount earned

List all extracurricular activities (school and community) in which you have participated during the last 4 years without pay
(e.g., Red Cross, church, sports, volunteer work). You may add more to the text box below.

ActivityNo. of years
Special awards, honors received

List any additional activities, number of years participated, special awards and honors here:

Please report any unusual family or personal circumstances you feel warrant attention here:

Other members of immediate family:

Relationship to parentAge (if less than 21)Degree of Dependency (entirely, 1/2, etc.)

List brothers and sisters in college:

NameAgeSchoolYear in school

Letters of Recommendation: Applicant must submit letters of recommendation (refer to INSTRUCTIONS for guidelines). The names and occupations of the persons (relatives excluded) who are writing the letters of recommendation are:

Full Name:   Occupation:

Full Name:   Occupation:

Applicant: Describe the most important educational, personal and leadership experiences that have led you to pursue a university education. Include reasons for your choice of major subject and your plans for the future. Use this space only

Signature*:  Date:
*Typing your name here is the same as signing your name

Final Checklist: Please remember to submit your transcripts and letters of recommendation as part of your final submission.