STALLION SERVICE AUCTION SCHOLARSHIP
Application Guidelines
(Revised 5/1/2018)

1.	Any senior 4-H member (age 14-18 as of 1/1/current year) enrolled in Carbon County who is or has been enrolled in the Carbon County horse program is eligible for this scholarship.  Member may win scholarship only once, non-successful applicants may reapply.  One scholarship will be awarded each year.

2.	This scholarship is to any college, university or trade school of the recipient’s choice.  Money will be sent directly to the school upon verification of enrollment.  If winner has already enrolled in school and paid his tuition, scholarship can be applied towards next semester’s fees.

3.	If recipient wins the scholarship before their senior high school year, the funds will be held in the fund in recipient’s name until the time of enrollment into a school of higher learning.

4.	If recipient chooses not to pursue further education after high school or reaches their 21st birthday without using the scholarship, the money will remain in the fund - except for extenuating circumstances such as Armed Services, etc.  In any case, the foundation’s decision will be final.

5.	Recipient must complete one semester of school on this scholarship or be liable to refund the money to the scholarship fund.

6.	If no qualified application is received, scholarship will not be awarded for that year.  Recipient will be chosen by:
1.	50% 4-H horse activities
2.	25% other horse activities
3.	25% personal growth and contribution to others

Emphasis will be on outstanding participation, achievement, leadership, growth and development in the 4-H horse program.

7.	Applications are available at the County Extension Office.  Pages may be duplicated if necessary, but only requested information is allowed.

8.	In case of a tie, a personal interview will decide the winner.

9.	These funds have been made possible through many years of generous donations by horse people from around the county and state.  The funds will be administered by the Carbon County 4-H Foundation and all their decisions will be final.

10.	Applications due April 1st in the Carbon County Extension Office, Box 280, Rawlins, WY 82301. 

STALLION SERVICE AUCTION SCHOLARSHIP
Application Form

PERSONAL INFORMATION

Full Name: _________________________________________ Age (1/1): _______________
Social Security Number: __________________________ Date of Birth: _________________
Mailing Address: _____________________________________________________________
City: _______________________________	State: ___________	Zip: ____________

Parent/Guardian Name/s: _____________________________________________________

High school you attend: _______________________________________________________

College/Institution you plan to attend: ____________________________________________
Enrollment date: _____________________________________________________________
Field of Study: ______________________________________________________________

Reasons for decision to study chosen field and college choice: ________________________
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Current picture to be used for media purposes. 

									

Signature of Applicant:________________________________________ Date: ___________

Signature of Parent/Guardian: __________________________________ Date:___________ 

4-H CLUB ACTIVITIES

Number of years in 4-H: _____ and/or FFA: ______

Are you active in your Community Club? ______
Offices held or committees served: ______________________________________________
__________________________________________________________________________
__________________________________________________________________________
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Number of years in horse project: _______

Awards won: ________________________________________________________________
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Number of years in veterinary science project: ______

Awards won: ________________________________________________________________
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Number of years in horseless horse project: ______
Awards won: ________________________________________________________________
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Number of horse demonstrations: ______, speeches: ______, horse bowl competitions: ____ during your 4-H years. Please list: _______________________________________________
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Awards won: ________________________________________________________________
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Number of years in horse judging: ______
Awards won: ________________________________________________________________
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Awards won on horse record books: _____________________________________________
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HORSE EXHIBIT AWARDS

Name of horse____________________________ Year/s of Competition: ________________
County awards won: __________________________________________________________
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State awards won: ___________________________________________________________
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Name of horse____________________________ Year/s of Competition: ________________
County awards won: __________________________________________________________
__________________________________________________________________________
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State awards won: ___________________________________________________________
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Name of horse____________________________ Year/s of Competition: _______________
County awards won: _________________________________________________________
__________________________________________________________________________
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State awards won: ___________________________________________________________
__________________________________________________________________________
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Name of horse____________________________ Year/s of Competition: ________________
County awards won: _________________________________________________________
__________________________________________________________________________
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State awards won: ___________________________________________________________
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Name of horse____________________________ Year/s of Competition: ________________
County awards won: _________________________________________________________
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State awards won: ___________________________________________________________
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Name of horse____________________________ Year/s of Competition: _______________
County awards won: __________________________________________________________
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State awards won:  ___________________________________________________________
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OUTSIDE HORSE RELATED ACTIVITIES

Number of Lions Club Youth Horse Shows attended: ________
Awards won: ________________________________________________	Year: _________
___________________________________________________________	Year: _________
___________________________________________________________	Year: _________

Number of years as pony club member: ________
Awards won: ________________________________________________	Year: _________
___________________________________________________________	Year: _________
___________________________________________________________	Year: _________

Number of years as FFA horse member: _______
Awards won: ________________________________________________	Year: _________
___________________________________________________________	Year: _________
___________________________________________________________	Year: _________

Other participation: (ie: rodeo club, local saddle club, breed association participation)
__________________________________________________________________________

Awards won: ________________________________________________	Year: _________
___________________________________________________________	Year: _________
___________________________________________________________	Year: _________

EXTRACURRICULAR ACTIVITIES

Academic Honors: ____________________________________________	Year: _________
___________________________________________________________	Year: _________
Awards: ____________________________________________________	Year: _________
___________________________________________________________	Year: _________
Offices: ____________________________________________________	Year: _________
___________________________________________________________	Year: _________
Groups: ____________________________________________________	Year: _________
___________________________________________________________	Year: _________
Activities:___________________________________________________	Year: _________
___________________________________________________________	Year: _________

COMMUNITY ACTIVITIES

Church: _____________________________________________________	Year: _________
____________________________________________________________	Year: _________
Clubs: ______________________________________________________	Year: _________
___________________________________________________________	Year: _________
Service: ____________________________________________________	Year: _________
___________________________________________________________	Year: _________
Organizations: _______________________________________________	Year: _________
___________________________________________________________	Year: _________
Employment: ________________________________________________	Year: _________
___________________________________________________________	Year: _________

Other significant horse related activities you feel have made a major impact on your life:

What do you consider your greatest achievement in the 4-H horse program?

REFERENCES

We encourage applicant to attach three letters of recommendation to this application.  Suggested references: 4-H leader, teachers, and Community business people.