Donald A. Williams Soil Conservation Scholarship Application

1. Name

Last:
First:
Middle:

2. Present address (Street, RR, PO Box, City, State, Zip):

Phone number:  (     )
Email:

3. Permanent address (during summer or non-school) (Street, RR, PO Box, City, State, Zip):

Phone number:  (     )
Email:

4. SWCS membership status and years as a member:

_____Regular member
_____Student member

If you have not been a member for at least one year, you are not eligible for this scholarship.

5. References: Please attach three letters of recommendation to this application. We suggest you use your college or university advisor and two others of your own choosing.

6. Will you hold other SWCS scholarships or internships this coming fall?

____ Yes  If yes, you are not eligible for this scholarship
____ No

7. Are you an employee or immediate family member of the scholarship selection committee?

____ Yes   If yes, you are not eligible for this scholarship
____ No

8. Education:

a. High School

Name:
Location:
Number of years completed: ___
Diploma or equivalent received: ___ Yes ___ No

b. College or university:

Name:
Location:
Number of years completed: ___
Major course of study Degree, if any:

Name:
Location:
Number of years completed: ___
Major course of study Degree, if any:

c. List any other schools attended, such as vocational schools, industrial schools, etc.

Give date attended and subjects pursued.

9. Employment

a. Employer:
    Address:

b. Period of employment in natural resource area:
    from _________ to _________

c. Title of position:

d. Briefly describe duties of employment listed above:

10. List other full-time positions held (attach additional information if this space is not adequate):

Employer:
Location:

Title of position:
Years in position:

Nature of duties:

11. List professional societies, civic organizations, important committees, publishing and speaking activities, and other significant organizations or activities in which you participate(d):

12. List honors or special awards received in recognition of your professional or community activities:

College or University Study Program

If you are planning to study at an accredited college or university and taking scheduled courses for credit, complete items 13 through 20 and sign item 26. If your study program is of a special nature, skip items 13 through 20 and answer questions 22 through 25.

13. List the college or university where you plan to study.

Name of college or university:
Location:

14. When do you expect to enroll?

Month:
Year:

15. List number of semesters, quarters, or years you expect to attend

16. Do you plan to work for a degree:

____ Yes
____ No

17. May we contact your employer for information?

____ Yes
____ No

18. During your study period will you be on leave from your present position: ____be resigned from your present position:____ , or be on a part-time employed basis :____?

19. Do you intend to return to work for your present employer after completing your studies?

____ Yes
____ No

20. Attach a one-page letter describing your study program plans, including such items as the subject matter area to be studied, your attitudes toward conservation, your career plans, your financial need, sources of income while attending school, and other significant points that you feel will be important in evaluating your application for this scholarship.

Special Study Program

21. If you are planning a special study program, complete items 22 through 25. A special study program can be defined as any study program that does not involve formal course work at an accredited college or university as the major study activity. The following are some examples of special study programs:

(1) Spending time at a college or university working informally with a professor on a special problem or research project, including sitting in on some course work, doing library study, and consulting with college staff.

(2) A well-planned travel program to collect information, study work in progress, consult with experts, and in other ways improve your knowledge and enhance your job effectiveness and opportunities.

(3) Study at a recognized vocational or technical school.

(4) Study and work experience with a commercial or industrial organization or government agency.

22. When do you expect to start your special study program?

23. When do you expect to complete your special study program?

24. Have you worked with your employer, co-workers, or others in developing the program?

____ Yes
____ No

25. In a narrative not exceeding 1,000 words, describe the plans and details of your special study program. Provide sufficient information to show what you plan to do, how it is to be accomplished, and how it will benefit you in your present or future employment. Describe your need for financial assistance, sources of income while conducting your special study program, and give other details that you feel will help to evaluate your application. Prepare your narrative on a separate sheet or sheets and attach it to this application.

26. Signature of Applicant:
       Date:

Scholarship Applications may be submitted by email to: sueann.lynes@swcs.org.  You may also submit Scholarship Applications by U.S. Postal Service (1 copy only) to:  SWCS-Scholarships, 945 SW Ankeny Rd., Ankeny, IA  50023. Letters of recommendation may be faxed to: 515-289-1227. All applications must be received by February 13.  Both Forms of submission will receive a confirmation of receipt.  Late applications will not be considered.