Jim Graham Cooperative Leadership Scholarship Application

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On behalf of the CCNC we hope your school year is going well and are looking forward to graduation in the coming Spring! Because you attended the Cooperative Leadership Camp at some point during High School, you are eligible to apply for a $1,000 college scholarship. Please fill out the entire application and submit by the due date. In addition, please make sure to print the instructions page and mail in your signature page with supporting documents. The winner will be honored at a luncheon at the Council's annual meeting.

Jim Graham is a renowned agricultural leader, an active supporter of the Cooperative Leadership Camp and North Carolina's former Commissioner of Agriculture.

Email *

Eligibility Requirements: *

Must have attended the full week of the Cooperative Leadership Camp

Must be a current high school senior graduating in 2023

Must be enrolled or plan to enroll as a student to an accredited two or four-year trade school, college or university, public or private

Required

Application Requirements: *

Completed scholarship application and answer essay (can be mailed in with signature page. Can be found online or print this form and sign and mail.) )

Print, sign and mail in signature page to: CCNC, PO BOX 10426, Raleigh NC 27605

Letter or recommendation from school/co-op. Have postmarked by March 1st to CCNC, PO BOX 10426, Raleigh NC 27605

All submitted and postmarked by March 1st, 2023.

Required

Disbursement of Funds *

Scholarship recipient will be notified during the spring semester and will be asked to send a video in to be shown at the annual meeting. The recipient must notify the Cooperative Council when they are enrolled as a student and the institution of their choice. Funds will be disbursed directly to the institution by the Cooperative Council after the student has enrolled, to be used towards any educational expenses. Please type below: I Understand.

Judging Criteria *

All applicants will be considered according to established rubric of criteria. A scholarship committee will judge the applications with emphasis on leadership essay, extracurricular activities, community involvement and demonstration of self motivation in the essay. Please type below: I Understand.

Name: *

Street Address: *

City: *

Zip Code: *

Date of Birth: *

YYYY

Phone: *

High School: *

Year attended CLC? *

Letter of Recommendation from name and title: *

Letter of Recommendation Contact (Phone and Email address) *

Name of Local Newspaper: *

College, University or Trade School You Plan to Attend:

Other Scholarships You Have Received (include amounts):

Please describe any extracurricular activities (include any leadership positions held and the school year (S) in which you participated in each activity):

Please describe any community, civic or other activities (include community activities, honors, leadership roles and/ or rewards):

Work Experience (please include present and previous employment, the dates you held each position, and explain your responsibilities/ duties):

Essay: What did you learn from Cooperative Leadership Camp and how do you currently apply what you learned at CLC? (You can print and mail in essay with signature page if preferred, type mail in if you decide to do so.) *

I have read and understand the enclosed information. I affirm that the information provided on this application form and any additional material that I submit related to this scholarship process is complete, accurate and true to the best of my knowledge. I hereby authorize the Cooperative Council of North Carolina to access the scholarship application information provided by me, as well as other official and unofficial information regarding my academic progress at status, for the purpose of providing information concerning my eligibility as a scholarship recipient. I understand that furnishing false information may result in revocation of my scholarship funding, if selected as a recipient. I also understand that if selected as a recipient I do not meet the requirement of registering as a full-time student to an educational institution, I will not receive the scholarship funds. *

YYYY

Student Signature (print page, sign form and mail): *

YYYY

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