G.R.O.W. Club Academic Scholarship

Full Name

SSN#

Birth Date

Current Address

Home Phone

Cell Phone

Email Address

Years of Subordinate Grange Membership

Grange Name and Number

Name of High School

City

College where you are to be enrolled

College City and State

Major

Expected Graduation Date

List Grange Activities you've participated in over the last three years on Local, Pomona, Regional, State and National levels.

List school and other non-Grange Activities in which you are involved. Include extracurricular activities, service projects and office or leadership positions held.

Please list Awards and Recognition over the last three years.

Explain you long-range goals for school, employment.

Explain how your experiences in the Grange will benefit your future.

Official Transcript: Graduating high school seniors must submit high school transcript. Those who has completed any semesters of college and are currently enrolled in college must submit an official college transcript.

ONE letter of recommendation from a leader in your Subordinate Grange who is not your relative.

ONE letter of recommendation from your State Master (president)

ONE letter of recommendation from a source other than a relative.

I certify that all information on this application is true and complete to the best of my knowledge. If requested, I agree to give proof of the information on this application. I understand that the selection committee may review information on this application and my transcripts. I acknowledge that I disclose my Social Security Numbers as a voluntary but necessary action for the purpose of identification. If selected to receive a scholarship, I give permission for a publicity release.

First Name Last Name