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Student Information

First Name

Last Name

Date of Birth

Mailing Address

City

State

Zip Code

Primary Phone

Member Company Affiliation

UnitedAg Member Company

Employee First Name

Employee Last Name

Relationship

Vocational School / Institution Information

Vocational School Name

Address

City

State

Zip Code

Expected Vocational Certification

Vocational Certification Start Date

Note: If you don't know your exact start date, choose an estimated date.

Expected Completion Date

Note: If you don't know your exact completion date, choose an estimated date.

Tuition Cost for Vocational Certification

Comments

Attach Files

Please attach the following:

(1) A one-page typed resume of your work, community service, and education.
(2) Two (2) letters of recommendation from supervisors and/or management from your company.
(3) A .JPG photo of yourself.

Questionnaire

Please describe why you would like to receive an AEF Vocational Scholarship.

Please describe any successes you have had in your career.

What future professional and personal goals are you looking to achieve?

Agreement

I hereby certify that all information provided in this application is true and correct. I further agree that if I withdraw from school or transfer schools during the term of this scholarship (if granted), that the unused balance is forfeitable to the Agribusiness Education Foundation, and I shall notify UnitedAg within 30 days. I also give UnitedAg permission to publish my name, photograph, resume and essay in any public relations materials, press release or publication produced and disseminated by UnitedAg.

I agree.

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