KY Department of Education								Due February 15 to
Division of Secondary Vocational Education						State Adviser
Family and Consumer Sciences Education	

APPLICATION FOR SCHOLARSHIP
KENTUCKY ASSOCIATION FAMILY, CAREER AND COMMUNITY 
LEADERS OF AMERICA

ELIGIBILITY:

A.	Plans to pursue a degree in Family and Consumer Sciences in a Kentucky college or university.
B.	Is an active FCCLA member who has made outstanding contributions to FCCLA.
C.	Has an overall scholastic standing of at least a "B" (3.0) for the four years of high school.
Individuals with less than a "B" (3.0) standing will be disqualified.
D.	Possesses desirable personal qualities as poise and self-control, has a neat appearance and is punctual, well-		mannered and dependable.
E.	Has shown leadership in school and community

HOW TO APPLY:
* Application must be typed.
A.	 Complete Parts I-VI in duplicate.  Keep one copy and send one copy to:  State FCCLA Adviser, 300 Building 5th floor, 300 Sower Blvd., Frankfort KY 40601, postmarked on or before February 15.
B.	Ask your guidance counselor to complete Part V.
C.	Ask each of the three persons listed in Part VI to write a letter of recommendation and mail to the State Adviser on or before 	February 15.

PART I  OBLIGATIONS OF SCHOLARSHIP RECIPIENT

Members who receive a scholarship have obligations to the Family, Career and Community Leaders of America.  Recipients will:

A.	Follow through with plans for attending a college or university in Kentucky with a major in Family and Consumer Sciences.  If it is impossible to fulfill this requirement, the State Adviser should be notified by July 1.
B.	Acknowledge receipts of scholarship checks sent by the State Adviser.  One half of the scholarship will be sent to the 	recipients’ home in August and the second half in December.
C.	Inform the State Adviser immediately if it becomes necessary to drop out of college or change the major before completion of the year.  Scholarships are to be used only for attendance in a Kentucky college or university for a degree in Family and Consumer Sciences.
D. 	Become an alumni member of Family, Career and Community Leaders of America by paying dues in that organization and promoting FCCLA and Family and Consumer Sciences careers to others.

"I agree to the obligations listed in the above statements."

Signed:

__________________________________________________      ___________________________________________________
.         			Applicant						Parent(s) or Guardian

Date: ______________________________________________ Date: _______________________________________________

"I have talked to_______________________________________________about the obligations of this scholarship and feel there is a sincere commitment to pursue a Family and Consumer Sciences career."

Signed: _____________________________________________________ Date: _________________________________________
FCCLA Adviser			

PART II    PERSONAL INFORMATION

Name___________________________________________Home Phone_______________________________

Home Address:	Street/Number___________________________________________________________

          			City/Zip________________________________________________________________

School: ___________________________________________________________________________________

School Address:	Street/Number____________________________________________________________

City/Zip_________________________________________________________________

Parents or Guardian: _________________________________________________________________________

PART III    CAREER PLANS

College or University you plan to attend in Kentucky: _______________________________________________

Family and Consumer Sciences major you wish to pursue: ____________________________________________

Write a paragraph telling why you are interested in this major and describe your personal qualifications that will help you succeed in this area.

Write a paragraph telling what you see yourself doing ten years from now.

PART IV   	FAMILY, CAREER AND COMMUNITY LEADERS OF AMERICA, SCHOOL AND COMMUNITY ACTIVITIES

Number of years in Family and Consumer Sciences (including Jr. High/Middle School) __________________

Number of years in FCCLA__________________

Activities and Recognition:  List major activities, offices, responsibilities or outstanding recognition.  Use only
the space provided on this sheet:

FCCLA ACTIVITIES

Chapter							Region

State								National

Other School Activities

Community Activities

PART V      ACADEMIC RECORD

Student's Name_____________________________________________________________________________

Overall Scholastic Standing________________________________(Count A-4, B-3, C-2, D-1)

Weighted Grade Point Average (if applicable)_______________________________________

Ranking in Class_________________________________Number in Class______________________________

Average Grade in Family and Consumer Sciences______________________________

ACT Score_______________________________________SAT Score________________________________

Date__________________________________Signed: _____________________________________________
       Guidance Counselor

PART VI    RECOMMENDATIONS

Give names, titles and phone numbers of three persons other than the Family and Consumer Sciences teachers or FCCLA Advisers whom you have asked to write a letter of reference as recommendations for this scholar-ship.  One letter should be from the school principal.  Have these letters mailed on or before February 15 to the State FCCLA Adviser, 300 Building 5th Floor, 300 Sower Blvd., Frankfort KY 40601.

(1) Name________________________________Title___________________________Phone______________

(2) Name________________________________Title___________________________Phone______________

(3) Name________________________________Title___________________________Phone______________