Monroe County Extension & 4-H Education Foundation
SCHOLARSHIP
Application Criteria

Applicants must be seniors in high school and/or have not reached
their nineteenth birthday on or before September 1, 2015.

4-H members can only receive the Scholarship once.

Applicants must be accepted into or be attending a post-high school
education program.

Recipients must provide information on the Office of Student Financial
Aid Form where the check will be sent.

Applicants must have been enrolled in a 4-H club program for at least
four consecutive years.

Applicants must thoroughly complete the application and submit
both a teacher and a 4-H club leader/community volunteer character
reference. The application must be completed using a Word
processing computer program and be signed by the applicant.

Scoring Criteria:
4-H Participation & Leadership .................................................... 40
School/Community Activities & Leadership ................................ 25
Educational Plans & Career Goals ............................................... 10
Recommendation Letters (2) ........................................................ 10
Format and accurate use of grammar and spelling ....................... 15

Applicants must submit a one-page report within six months of the
date the scholarship was received. The report should describe how
their continuing education has enriched their lives.

Completed applications must be postmarked by April 12, 2016.
Faxed applications will NOT be accepted.

Applications should be sent to: University of Illinois Extension,
P. O. Box 117, Waterloo, IL 62298
The committee will award each selected recipient with a
$1,500 scholarship. The check will be sent to the Office of Student
Financial Aid where the recipient will be attending.
This scholarship fund was established in February 2002, by memorial funds from the family
and friends of Wilbert Sensel. Additional contributions continue to support the scholarship.
The scholarship will help young people enrich their lives through continuing education.
Monroe County Extension & 4-H Education Foundation
Scholarship Application
Application must be prepared using a word processing program.
Part I: General Information to be included:
1.
Full Name, Gender, Date of Birth
2.
Complete Home Address
3.
Telephone Number and email address
4.
Current High School/College/Trade School and grade point average
5.
Date of Graduation
6.
Father’s name in full
7.
Mother’s name in full
Part II: 4-H Participation, Leadership and Recognition- 40 points
1. Thoroughly describe what you have learned and gained through your 4-H experience. How has your
involvement and activity helped you learn: work preparation skills, interpersonal skills, organizational skills and
leadership skills. (2 or more pages)
2. List the years and projects in which you have been involved in the 4-H program. (If any of your 4-H involvement
was in a different county or state other than Monroe County, Illinois, please indicate the county and state.)
3. Describe your 4-H experience, including 4-H club leadership, 4-H Federation, 4-H Ambassador, awards &
recognition, community service, county and state opportunities. (2 or more pages)
4. Why do you feel you should be awarded a Monroe County Extension & 4-H Education Scholarship? (500 or
more words)
Part III: School Activities & Leadership, Community Involvement & Leadership, Recognition and
Experience -25 points
1.
List the student activities in which you participated in high school. Indicate offices and positions of leadership
as well as any honors you received based on your participation. List academic awards you have received.
Describe how your involvement helped with life skill development
2.
List your high school grade point average.
3.
Describe any employment and/or volunteer experiences you have had during school or during summer
vacations.
Part IV: Academic Plans-10 points
1.
Name and location of the college, university or vocational school(s) where you plan to or are attending.
2. Briefly state what your major field of study will be.
4.
Describe other employment plans/scholarship(s) to help financially support your continuing education.
4.
What are your career goals?
Include your signature and date and send or drop off the complete application package at
the U of I Extension Office, 901 IL. Ave., P.O. Box 117, Waterloo, IL 62298
Monroe County Extension & 4-H Education Foundation
Scholarship Application
4-H Club Leader /Community Volunteer Character Recommendation
1. Describe how you know the applicant.
2. Describe the character traits of the applicant.
3. Describe the applicant’s leadership growth through their 4-H involvement.
4. Describe the applicant’s involvement in the community.
______________________________________________________________________________
______________________________________________________________________________
5. Why do you believe this applicant should be awarded a Monroe County Extension and 4-H
Education Foundation Scholarship?
Signature: ___________________________________________________
Name:
___________________________________________________
Address
___________________________________________________
Phone
____________________________________________________
Date:
____________________________________________________
Upon completion, return to applicant in a sealed envelope
Monroe County Extension and 4-H Education Foundation
Scholarship Application
(To be completed by a teacher who has had the student in class)
Student Name _________________________________________________________________
Teacher Reference _____________________________________________________________
Date ___________________________________
1. Please describe the character strengths and academic strengths of this student.
2. Please describe the student’s leadership which you have observed and/or been connected through
a class and/or organization with this student.
3. Describe why you believe this applicant will succeed in his or her chosen course of study.
4. Additional comments:
Signature:
_________________________________________________________________
Name:
_________________________________________________________________
Address:
____________________________________________Phone________________
Date:
__________________________________
Upon completion, return to applicant in a sealed envelope.