Paulding County Master Gardeners

Paulding County Cooperative Extension

530 West Memorial Drive

Dallas, Georgia 30132

1. The total amount to be awarded will be administered by a scholarship committee. The award will be issued in accordance to the rules set forth in the Paulding County Master Gardener Scholarship Guidelines and this application.

2. It is the responsibility of the recipient to furnish any needed information (acceptance letters, proof of enrollment, for example) required for disbursements of scholarship funds. The recipient should allow 4 weeks for processing and be aware of all local scholarship deadlines.

3. The recipient is expected to remain a student in good standing at the post-secondary institution. The Paulding County Master Gardeners should be notified by the student immediately upon a status change. Grade reports or other data may be requested and must be submitted upon request. Failure to remain a student in good standing may endanger the receipt of the funds for the remaining balance.

4. In the event a student is unable to complete a quarter/semester at the post-secondary institution and must withdraw from school, written notification must be made to the Paulding County Cooperative Extension office. Reasons for withdrawal must be clearly stated, as well as intentions for the future. The local scholarship committee reserves the right to request restitution of monies expended for the quarter/semester of withdrawal from the post-secondary insitution.

5. If the recipient fails to correspond with or contact the committee for 2 consecutive terms, he/she will be considered withdrawn from the school and will forfeit all monies left in the scholarship.

6. Local scholarship monies should be used within 1 year. Unused scholarship funds will be returned to the local scholarship fund.

I have read the above rules and regulations governing the acceptance of the scholarship, and I agree to abide by them if chosen to receive a scholarship.

______________________________________________ _________________________________

Recipient’s Signature Date

Paulding County Master Gardeners

Local Scholarship Program

1. Full Legal Name: ____________________________________________________________________

2. Address: ________________________________________________Phone # ___________________

3. Date of Birth: ____________________________________________ Student ID # _______________

4. Where do you plan to attend college? ___________________________________________________

5. What is your intended college major? ___________________________________________________

6. When do you plan to begin college? ____________________________________________________

7. What course of study have you pursued in high school? CP ________ TC ________ Dual _______

8. List the names and occupations of at least 3 people whom you will be using as references for the local scholarship. Tell how long you have known them. (Print 3 copies of the reference form and have these people complete them, seal them in an envelope with their signature across the seal and return them to you to be submitted as part of a completed application package.)

9. Please list high school you attend(ed): ___________________________________________

If you attended any other high schools, please list each one.

10. List any clubs or organizations to which you belong. Give any office that you may have held.

11. List any awards or honors you may have won.

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

12. List any community or church organizations to which you belong. Give evidence of your level of responsibility. ____________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

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14. Have you received other scholarships? If so please list.

________________________________________________________________________________

15. Have you applied for other scholarships? Please list them.

________________________________________________________________________________

16. Why are you applying for the local scholarship?

17. Suppose there is only one scholarship that is available. You and one other equally qualified candidate are the finalists being considered. Why should you be the student chosen to receive the scholarship?

For Completion by High School Counselor Only:

GPA________________ Class Rank_________ out of ___________

Signature of High School Counselor ______________________________________________________

Printed Name of HS Counselor _______________________________________________________

Date Completed: __________________________

If you are not currently enrolled at a High School, please submit your most recent transcript (High School or College).

Deadline for returning all forms: 5 PM, April 29, 2011

Please return this form to: Paulding County Master Gardeners

Attention: Scholarship Committee

530 West Memorial Drive

Dallas, Georgia 30132

Paulding County Master Gardener

Scholarship Reference Form- Print 3 copies of this reference form and have the references listed on your application complete it, seal it in an envelope with their signature across the seal and return it to you to be submitted as part of a completed application package.

Name of Applicant: ____________________________________________________________________

Name of Reference: ____________________________________________________________________

Occupation of Reference: ________________________________________________________________

How long have you known the applicant? ___________________________________________________

In what capacity? ______________________________________________________________________

If appropriate, please rate the applicant on the following characteristics.

	Below Average	Average	Above Average	Exceptional
Analytical Skills	_____________	_____________	______________	_____________
Classroom Discussion	_____________	_____________	______________	_____________
Creative Thinking	_____________	_____________	______________	_____________
Growth Potential	_____________	_____________	______________	_____________
Initiative	_____________	_____________	______________	_____________
Intellectual Skills	_____________	_____________	______________	_____________
Written Expression	_____________	_____________	______________	_____________
Integrity	_____________	_____________	______________	_____________
Personal Appearance	_____________	_____________	______________	_____________
Dependability	_____________	_____________	______________	_____________
Character	_____________	_____________	______________	_____________