Application - Deadline May 1, 2023

2023 Scholarship - $500 (Multiple scholarships available)

Eligibility Requirements: The Scholarship committee is looking for students interested in the agriculture or engineering field, and have demonstrated a commitment to self, school, and community. Applicant must be:

  • A current high school senior at Lodi High School or Tokay High School
  • Pursuing a career in agriculture or engineering
  • Planning to attend a Vocational School, Junior College, Community College, or a four-year Accredited College or University in the Fall of 2023
  • Able to demonstrate personal determination and involvement in school and community.
Questions can be addressed to or call Lodi Adopt-A-Child at 209-333-1056.

Note: If you sign in with a Google account, you will be able to return to this form at a later date and edit your responses.  However, you must complete the application before the May 1st deadline.

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Personal and Contact Information
Full Name *
First and Last Name
Email *
Email address where you can be contacted
Address *
Street address.  Also include mailing address, if different
Phone *
Phone number with area code (nnn-nnn-nnnn)
Date of Birth *
Academic, Extracurricular and Career Information
Tell us about you, what you've accomplished and your goals
Current High School *
Grade Point Average (number only)
College(s) or Trade/Vocational schools applied to *
What school(s) do you want to attend next school year?
Career goal *
Your career goal and area of study
Why are you considering this profession and describe any prior experience you have related to this profession, if any. *

Describe any clubs, youth groups or other community organizations you are involved in

Describe any school or community awards, recognitions, or honors you have received.

Describe any hobbies or interests you have
Include any not already covered above

Please prepare a personal statement about yourself and why you think the Claude Brown Scholarship would help you (300 words or less).

Additional information (Optional)
Is there any other information or comments that you would like to convey to the scholarship committee regarding your application.
Letter of Recommendation
You must provide at least one letter of recommendation regarding your character, school, and/or community involvement.  This could include a teacher, counselor, another school staff member or a community member outside the family.

Recommendations may be 
  • Emailed to (Subject:  Claude Brown Scholarship and <your name>)
  • or mailed to:  Claude Brown c/o Lodi Adopt-A-Child, Inc, PO Box 2479, Lodi, CA 95241-2479
Name of person providing recommendation
Though not required, providing us with the name(s) of the person(s) writing your letter of recommendation will help us make sure that we match the recommendation to your application.
High School Transcripts
Please submit your official high school transcripts to Lodi Adopt-A-Child, Claude Brown Scholarship Committee emailed to or mailed to:  Claude Brown c/o Lodi Adopt-A-Child, Inc, PO Box 2479, Lodi, CA 95241-2479

If the applicant is awarded a scholarship, he/she must:

  • Be enrolled as a full-time student for the 2022-2023 academic year
  • Be able to provide proof of current registration

Is this application complete?
Please confirm whether your application is complete.  If so, we will process your application.  If not, we will assume that you plan to come back later to complete the application.  Please return and complete it by May 1st.
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