Berks County Community Foundation-4H Application

The Jim Haldeman Berks County 4-H
Scholarship Fund Application
Scholarships are available for graduating seniors enrolled in post-secondary education who have been for the past three years and currently are (as of January 1st) members in good standing of the Berks County 4-H Program, and who best exemplify the fundamental values guiding 4-H members. Preference will be given to members who remained active in 4-H in the last three years.

To be considered for this scholarship, complete and submit the form below electronically between January 15th and April 1st.

In addition to submitting the form below electronically by April 1, you must mail in the following attachments postmarked no later than April 1. Put your name on all mailed submissions:

A copy of your most recent high school transcript.
Three letters of recommendation. One letter must be from a 4-H leader and two letters should be from individuals who can provide information about you. This letter should be from a teacher, school official, clergy, employer, advisor, community leader or other person who knows you well.

Mail the above information to:
The Jim Haldeman Berks County 4-H Scholarship
Berks County Community Foundation
P.O. Box 212
Reading, PA 19603-0212

Please fill out the form below and submit electronically:

Applicant Name:

Prefix	First	MI	Last	Suffix

Street Address:

Address 2 (optional):

City:

State: Zip Code: County

Home Phone Number:

Email address:

Township/Borough:

High School Name:

Graduation Date:

Post-Secondary Plans

What educational institution are you planning to attend?

Educational institution location:

Have you been accepted? Yes No

Briefly describe the course of study you will pursue:

4-H Involvement

Which 4-H Clubs are you enrolled in? Indicate the years you were enrolled in each (example: Berks County 4-H Club (1999-2007).

Describe the three 4-H activities that had the biggest impact on your 4-H career and why their impact was so memorable and/or important. (Activities can include club, county, and/or state events or projects.):

Describe all of the 4-H leadership positions you have held over the past three years. (Leadership positions can include teen leader, club officer, committee chairperson, advisory board/council representative, etc.):

Describe your involvement in community service projects at the club, county, regional and /or state level over the past three years. (Example: I participated in club visits to Berks Heim (2005, 2006, 2007) where we played bingo with the residents.):

List the major awards you have received in the 4-H Program over the past three years. Be sure to indicate the year received. (Example: 2006 Senior Division Record Book Award Winner):

Activities, Awards and Honors
List all school activities (outside of 4-H) in which you have participated in the past three years:

List all community activities (outside of 4-H) in which you have participated in the past three years:

Indicate all special awards, honors and offices held (outside of 4-H) in the past three years:

List any work experience you have had in the past three years, even if unpaid. (Example: Checkour cashier, Target, Wyomissing - 2007):

Please attach a one-page essay on the topic "Why would you encourage a younger child to participate in 4-H?"

How did you hear about the Community Foundation?

Note: Berks County Community Foundation employees, board members and/or committee members are not eligible to apply or be nominated for a grant or scholarship, nor are their immediate family members. Immediate families include spouses, children, stepchildren, grandchildren, and stepgrandchildren. The ineligibility period for Berks County Community Foundation board members or employees extends five years after board service or employment terminates. The ineligibility period for committee members who are not Berks County Community Foundation board members or employees is in effect only during their term of service.