Susie and Leigh Waugh Scholarship

The Susie and Leigh Waugh Scholarship is for any Columbia City High School senior planning on pursuing a baccalaureate degree and majoring in agriculture or FCCLA (Family Career and Community Leaders of America.

Application Deadline:

Application Due April 15

Instructions

You will not be able to save this application or come back to it later. If you close out your browser, you will need to start your application over.

Please review this form and have your responses ready. It is advised to prepare your answers in advance. You may also copy and paste your answers from Microsoft Word or other text based programs.

Applicant Information

Name*

Last four digits of your social security number

Date of Birth*

Phone*

Address*

City State Zip*

Please tell a fun fact about yourself.*

Please upload a picture of yourself.*

Email*

Re-enter Email*

Family Information

Mother Name

Mother Occupation

Father Name

Father Occupation

Number of siblings and their ages

High School Data

Please attach a copy of your school transcript for all years attended at Columbia City High School.*

How have you prepared for in high school for a career in FCCLA (Family Career and Community Leaders of America) or agriculture?*

Advanced Education/Vocation Data

School you plan to attend

Have you Applied?

If yes, have you been accepted?

Major field of study

Educational/Vocational Objective

Employment Data

Describe any work experience during the past four years. Please list the employers, the position you held, and the length of employment/hours.

How did working influence you, or what did you learn from it?

Activities/Awards Data

Describe any extracurricular, community and humanitarian activities you have participated in during the past four years. Indicate any special awards or honors received.

Personal Comments

Why did you choose the field agriculture or (FCCLA) Family Career and Community Leaders of America?*

Validation

I hereby certify that the information is complete and accurate to the best of my knowledge. My validation indicates my permission to release the attached personal and all academic records to this scholarship review/approval process. I also agree to be personally interviewed by the scholarship advisors and/or representative teachers. If under 18 years old, a parent or guardian’s validation is required.*

Security

Please enter the code