Application

JACKSON HOLE RODEO SCHOLARSHIP

7785 COWBOY WAY

JACKSON, WY 83001

Name of Student___________________________________________________________________________

MailingAddress __________________________________________________________

________________________________________________________________________

Home Phone # ______________________________Date of Birth __________________

School Information: _____________________________________________________ ________________________________________________________________________

___________________ Graduation Date _________________________

Cumulative GPA __________ Decile Rank from top of class ______________________ Highest ACT or SAT ACT Composite _______________ Date ___________________ SAT Crit. Reading ________ Math __________Writing ________ Date ___________

Parent/Guardian information:

Father _____________________________Mother _____________________________
Employer __________________________ Employer __________________________

Home Phone ______________________ _ Home Phone ________________________
Siblings’names and ages _________________________________________________________ Please circle those presently attending college and list location of college.

Names of colleges/universities applied to and annual tuition costs (excluding room/board)

1._________________________________2._________________________________ 3._________________________________4._________________________________ 5._________________________________6._________________________________

Intended Major ________________________________________________________________

Estimated annual family income (please check):

Under $29,000 ____ $29,001-$49,000 ____ $49,001-$69,000 ____ $69,001-$89,000 ____ $89,001-$100,000 _____ $100,001-$150,000 _____ Over $150,000 _____

Amount to be contributed by family ____________ Amount saved by student ________

Brief employment history of student. Start with the most recent employment:

Have you applied for and/or received any other financial aid or scholarships? If YES, please explain: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Extra-curricular activities: List clubs, organizations, church groups, community service, athletics, band, orchestra, etc. Include leadership positions, honors and awards and dates of participation. Attach extra pages if needed. ________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

In 100 words or less, answer the following question: What are your education and career plans and how would this scholarship advance the sport of rodeo or our western heritage? Attach extra pages if needed.

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Is there any additional information you would like the scholarship committee to be aware of? Attach extra pages if needed. ________________________________________________________________________________________________________________________________________________________________________________________________________________________

List names, addresses and phone numbers of three people (not in your family) who can act as references:

1._________________________________________________________________

2._________________________________________________________________

3._________________________________________________________________

Student signature _____________________________________________________________

ATTACH HIGH SCHOOL TRANSCRIPT!!!

IT IS THE STUDENTS RESPONSIBILITY TO BE AWARE OF APPLICATION

DEADLINES AND TO MAIL THIS APPLICATION ON TIME!!!!!