4-H Scholarship Application

URL

This field is for validation purposes and should be left unchanged.

Applicant Name*

Enter the name of the student applying for the scholarship.

Parent or Guardian Name (if applicable)*

Please enter the name of your parent or guardian (if applicable).

Home Address*

Street Address Lot, Apartment, or Unit (optional) City State ZIP Code

KREMC Account Number*

Please enter the KREMC account number associated with your home address. If you are the child or dependent of a KREMC member, please ask your parent or guardian for this information.

Contact Phone Number*

Please enter the best phone number for us to contact you at.

Phone Type*

Please choose what type of phone your contact number is.

Home/Landline

Mobile

Email Address*

Enter your email address.

School*

Enter the name of school you attend.

Grade*

How will this scholarship make a difference for you?

Describe the 4-H project the scholarship money would be used for.

Why should you receive this scholarship?

Is there anything additional you would like the scholarship committee to know?

Video Upload*

One file only.

Accepted file types: avi, mov, mp4, ogg, wav, webm, Max. file size: 100 MB.

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