2011 Stipend Application

Name:

Date of Birth :

Address:

Phone#:

Email:

High School:

Guidance Counselor:

Father (or guardian´s) name:

Mother (or guardian´s) name:

Professional or technical career objectives :
(If you exceed the number of characters provided here, please send an email to sbair14@yahoo.com with your full answer. Provide your full name in the first line of the email.)

Community/ School Activities (secondary and/or other):
(If you exceed the number of characters provided here, please send an email to sbair14@yahoo.com with your full answer. Provide your full name in the first line of the email.)

Teacher Reference #1

Name:

Address:

Phone:

Email:

Teacher Reference #2

Name:

Address:

Phone:

Email:

Please answer the following questions and send them via email to sbair14@yahoo.com.

• Be sure to include your full name on the first line of the email.
• You may type directly into the email or attach a Word (.doc) document.
• Answers should not exceed 300 words each.

1. Describe the value in forging a closer relationship between the Pennsylvania Young Farmers Association and FFA.

2. How would you benefit from participation in the National Institute?
    What ideas do you have for sharing the information you might gain with your fellow FFA members?