1. 2013
RETURN APPLICATION BY APRIL 15
Kentucky FFA Alumni WASHINGTON LEADERSHIP CONFERENCE Scholarship
The Kentucky FFA Alumni Association provides one or more Washington Leadership
Conference full and/or partial Scholarships (maximum value $550 ~ balance due $150).
Eligibility
1. FFA Chapters with an active FFA Alumni Chapter will be given priority.
2. Student must be an active FFA member.
3. Agricultural Education students who are in their 9th, 10th, or 11th grades of the
current school year are eligible. Current seniors are not eligible.
4. Only one application from a chapter should be submitted.
Deadline
Applications are due postmarked by April 15.
Return To:
Kentucky FFA Alumni Association
c/o Peter B. Dreisbach
111 FFA Camp Road
Hardinsburg, KY
40143-2529
Applicant's FFA Alumni Affiliate Number 16
APPLICATION
Name
(Last)
(First)
(Middle)
Address
Phone
(Street/route)
(City)
(Zip Code)
(A.C.) (No.)
FFA Chapter
Birthday
Age
(Mo/Day/Year)
Parents Name
Home Phone
Address
Business Phone
(Street/route)
Occupation of Father
High School
(City)
(Zip Code)
Mother
School Phone
Grade In School
(current year)

2. List Current Supervised Occupational Experience (SOEP)
Enterprise
Scope
% Candidate Share
Or
List Current Agribusiness Occupational Experience Program
Job Title or Type of Work
Hours
Worked
Place of Employment
Brief statement of career plans after high school
Attach the Following:
1. Completed (up-to-date) official "Record of FFA Participation" activity card.
2. Brief narrative on "Why I want to further develop my leadership abilities."
(No More than 300 words and in your handwriting)
Bind the material in an attractive folder. The margins should be sufficiently wide to permit
reading of material.
Signed
(Applicant)
Signed
Date
(FFA Advisor)
(Mo/Day/Year)