USDA 1890 National Scholars Program

Rev 2009_1890ScholarsApp

USDA 1890 National Scholars Program

OMB: 0503-0015

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0503-0015 can be found here:

Document [pdf]

Download: pdf | pdf

0 Independence Ave, SW Room 3038, South Bldg.,
USDA/1890 National Scholars Program Application

Section I (Information)

USDA/1890 National Scholars Program in the
Agricultural, Food, and Natural Resource Sciences
The USDA/1890 National Scholars Program will provide full tuition, employment,
employee benefits, fees, books, use of a laptop, printer, and software while on
scholarship and room and board each year for 4 years to students pursuing a
bachelor's degree at the following universities:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Purpose

Objective

Alabama A&M University
Alcorn State University, Mississippi
Delaware State University
Florida A&M University
Fort Valley State University, Georgia
Kentucky State University
Langston University, Oklahoma
Lincoln University, Missouri
North Carolina A&T State University
Prairie View A&M University, Texas
South Carolina State University
Southern University, Louisiana
Tennessee State University
Tuskegee University, Alabama
University of Arkansas, Pine Bluff
University of Maryland - Eastern Shore
Virginia State University
West Virginia State University

The purpose of the USDA/1890 National Scholars Program is:
•

to strengthen the long-term partnership between USDA and the 1890
Land Grant Universities

•

to increase the number of students studying agriculture, food, natural
resource sciences or other related disciplines

•

to offer career opportunities to USDA/1890 National Scholars at the
U.S. Department of Agriculture

The National Scholars Program offers scholarships to U.S. citizens who are
seeking a bachelor's degree at one of the eighteen 1890 Historically Black
Land-Grant Institutions in any field of study in agriculture, food, natural resource
sciences or other related disciplines. National Scholars are required to study in
the following or related disciplines:
•
Agriculture
•
Agricultural Business/Management
•
Agricultural Economics
•
Agricultural Engineering/Mechanics
•
Agricultural Production and Technology
•
Agronomy or Crop Science
•
Animal Sciences
•
Botany

Section I (Information)
•
•
•
•
•
•
•
•
•

Farm and Range Management
Fish, Game, or Wildlife Management
Food Sciences/Technology
Forestry and Related Sciences
Home Economics/Nutrition/Human Development
Horticulture
Natural Resources Management
Soil Conservation/Soil Science
Other related disciplines, (e.g., non-medical biological sciences, preveterinary medicine, computer science)

The Award

Scholarships are awarded annually and must be used at one of the eighteen
1890 Historically Black Land-Grant Institutions.
Each award provides annual tuition, employment, employee benefits, and use of
a laptop computer, printer and software while on scholarship, fees, books, room
and board for each of the 4 academic years, plus a requirement to work in the
Student Educational Employment Program. Each annual scholarship renewal is
contingent upon satisfactory performance and normal progress toward the
bachelor's degree. Upon completion of the scholar's academic degree program,
there is an obligation of 1 year of service to the U.S. Department of Agriculture
for each year of financial support.

Who may Apply

Applicants must be U.S. citizens that are high school seniors completing high
school diploma or a G.E.D. certificate and entering the first year of college and
pursuing a bachelor's degree.
(Note: Since this program is intended to increase the number of students studying
agriculture, food, natural resource sciences, or other related disciplines at
participating institutions, currently enrolled bachelor's-level students at these
universities are not eligible to apply.)

Application Deadline

All application materials must be postmarked no later than February 1 and sent to
the university(s) selected by the applicant to attend.

General Eligibility

Applicant must:
•
•
•
•
•
•
•
•
•

Be a U.S. citizen
Be a graduating high school senior.
Expect to hold a high school diploma or G.E.D. certificate
Have a high school GPA of 3.0 or better
Have a combined verbal/math/written score of 1,500 or more on the SAT
(note: 1000 or more combined for those universities that only accept
verbal/math score) or a composite score of 21 or more on the ACT;
Be interested in one of the eighteen 1890 Historically Black Land-Grant
Institutions
Intend to study agriculture, food, natural resource sciences, or other related
disciplines
Demonstrate leadership and community service
Apply and be accepted for admission to the institution(s) of his or her choice.

•

Submit an official transcript with the school seal and an authorized official's
signature

•

Submit signed applications (original signature only)

OMB No.: 0503-0015

Section II (Student)

Supporting Information of the
USDA/1890 National Scholars
Program
Privacy Act Advisory
Statement
Attention Applicant!
Complete pages 1 through 7 only.
PRINT pages 8-10 and submit to
your counselor

The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain
information in connection with this request for information. Accordingly,
pursuant to the requirements for the Act, please be advised:
1. The authority for the collection of these data is Executive Order
11155.
2. Furnishing the information requested is voluntary.
3. The data will be used for selection of USDA/1890 National Scholars,
printing of certificates, and related activities.
4. Other routine uses of the data are for preparation of the public affairs
and press releases to news media.
5. Failure to complete the form will mean that you cannot be included
among those candidates being considered for designation as
USDA/1890 National Scholar.

Affirmation of Candidacy and
Authorization for Release of
Information

I, _________________________________, understand that I am a candidate for
the honor of USDA/1890 National Scholar, have read the Privacy Act Advisory
Statement, and affirm my wish to be considered. In the event I am named a
National Scholar, permission is hereby given for the release of materials
submitted by me for the use of the U.S. Department of Agriculture and the
eighteen 1890 Historically Black Land-Grant Institutions as deemed
appropriate for purposes of the USDA/1890 National Scholars Program.
I further consent to the release of photographs which may be taken of me, by or for the
U.S. Department of Agriculture in connection with the Program. I am (check one)
willing ______ unwilling ______to appear on radio and/or television if such
arrangements can be made by the U.S. Department of Agriculture in connection
with the USDA/1890 National Scholars Program.

Signature: ______________________________________________________
Date:

____________________________________________________________
Enter date format as mm-dd-yyyy

Page | 1

OMB No.: 0503-0015

Section II (Student)

The questions that follow are designed to collect information about your
background, your interests, and your plans. Your answers to these
questions will be used only in connection with your application for this
scholarship program and will be divulged only to qualified persons who
must see them in the course of their duties.

Candidate’s Biographical
Questionnaire

Note: The selection of scholarship recipients will be influenced by the
completeness, neatness, and legibility of replies.
Please type or print, using black ink.

Biographical Information

Legal name in full (Please print) ________________________________________________________
Last
First
Middle

Sex

Permanent home address
Number and street

Telephone
Are you a U.S. citizen?

City/Town

__ ______________
Yes

State

Zip Code

Age

B. Education
1.

Name of high school now attending

City

GPA (on a 4.0. unweighted scale)

Telephone

State

ACT COMPOSITE SCORE

Zip code

SAT COMBINED SCORE

2. List any other schools that you attended in the last 4 years. List the schools in order of attendance, with the one you
attended most recently first.

Name of school

Location (city and state)

Page | 2

Dates of attendance

Section II (Student)
3.

List any advanced or special program, courses or summer courses you have taken. List the most recent course or program first.
Course or program

Name of school

Location
(city and state)

State

What course of study (major) will you pursue?

1st

2nd

Have you made any career decisions related to agriculture, food, natural resource sciences, or other related disciplines?
Yes

Hours per week

Name of 1890 University to which you are applying

City
5.

Dates of attendance

If yes, explain:

Do you plan to go to graduate or professional school? __________

If YES, field of study

* All Academic disciplines may not be available at each institution. Check institutions academic offerings before applying.

Activities

1. List activities (prioritize) in which you have participated in or outside your school (such as academic, publications, debating,
dramatics, sports, music, art, student government, and clubs).
Activity

Participation

Offices held

Special Awards, honors or recognition

Dates

Page | 3

Section II (Student)
2.

List volunteer services and jobs you have held in the past 4 years (including summer employment).
Volunteer
services or jobs

Name of
employer or organization

Dates of service
or employment

Hours per week

Special awards

Note: Be concise. Limit your answers to the space provided.

D. Leisure-Time Activities
1.

What is the most stimulating book or article (other than those for school assignments) you have read in the last 6 months?
Why did you find it stimulating?

What do you do for relaxation and fun?

Describe your leadership role in activities in both your school and community.

Please describe any characteristics of yourself or your family that have been important to your personal development.

Page | 4

Section II (Student)

Candidate’s Self Assessment

Describe a recent experience that has given you a sense of satisfaction or pride. Explain why you were satisfied or proud.

Briefly discuss why you want to study agricultural, food, natural resource sciences, or another related discipline in college.

USDA/1890 National Scholars application check list
❑ SECTION I.
❑SECTION II.

I have read this section, especially those elements detailing the eligibility requirements, schools that I must
attend, and the February 1 deadline in which all application materials must be postmarked.
I have read and filled out Section II, Student Self‐Assessment section. I understand Section II must be
postmarked no later than February 1, in order to meet the eligibility requirements.

❑SECTION III.

I have given Section III to my counselor/teacher to fill out. I understand this section must be postmarked no
later than February 1. Further, I have explained to my counselor/teacher the need to have all official
transcripts enclosed with this response and sent to the institution’s USDA Liaison Officer where I have
selected to attend.

❑SECTION IV.

I have applied for admission to each 1890 Historically Black Land‐Grant Institution of interest.

Please review this form to make sure you have answered all questions completely. Proofread your responses.

I certify that I completed this application and that all statements made are true and accurate to the best of my knowledge.
(A false statement could eliminate me from consideration for this scholarship.)

Date

Signature

This form must be returned to each 1890 Historically Black Land‐Grant Institution(s) of your choice.
MUST BE POSTMARKED BY FEBRUARY 1

Page | 5

Section II (Student)

1890 Institutions
USDA Liaison Officer
Alabama A&M University
School of Agricultural & Envtal Sciences
Room 300, Dawson Bldg. or PO Box 1087
Normal, AL 35762
USDA Liaison Officer
Alcorn State University
1000 ASU Drive, #1139
104 Agriculture Science Bldg.
Lorman, MS 39096
USDA Liaison Officer
Delaware State University
Dept. of Agriculture & Natural Resources
1200 N. Dupont Highway
Baker Bldg Annex, Rm 102
Dover, DE 19901
USDA Liaison Officer
Florida A&M University
1740 S. Martin L King Jr Blvd
S.Perry-Paige Bldg., Rm 217
Tallahassee, FL-32307-4100

USDA Liaison Officer
Prairie View A&M University
P.O. Box 2736
Prairie View, TX 77446-2736
USDA Liaison Officer
South Carolina State University
P.O. Box 7246
Orangeburg, SC 29117-0001
USDA Liaison Officer
Southern University College of Agriculture,
Family & Consumer Sciences
Fisher Hall, Rm 102
Baton Rouge, LA 70813
USDA Liaison Officer
Tennessee State University
3500 John Merritt Blvd.
Nashville, TN 37209-1561
USDA Liaison Officer
Tuskegee University
College of Agriculture, Environmental &
Natural Sciences
Campbell Hall, Room 103
Tuskegee, AL 36088

USDA Liaison Officer
Fort Valley State University
Agricultural Research Station
1005 State College Drive
Fort Valley, GA 31030-3298
USDA Liaison Officer
Kentucky State University
Cooperative Extn Bldg., Rm 227
400 East Main St
Frankfort, KY – 40601
USDA Liaison Officer
Langston University
School of Agriculture and Applied Sciences
100 Success Dr, Rm V115
Langston, OK 73050
USDA Liaison Officer
Lincoln University
108 Bennett Hall
818 Lee Drive
Jefferson City, MO 65101-0029
USDA Liaison Officer
North Carolina A&T State University
107 B.C. Webb Hall
Greensboro, NC 27411

Page | 6

USDA Liaison Officer
University of Arkansas Pine-Bluff
P.O. Box 4806, UAPB
1200 North University
Pine Bluff, AR 71601-2799
USDA Liaison Officer
University of Maryland-Eastern Shore
Trigg Hall, Rm 1137
Princess Anne, MD 21853
USDA Liaison Officer
Virginia State University
P.O. Box 9081
L. Douglas Wilder Bldg., Rm 204B
Petersburg, VA 23806
USDA Liaison Officer
West Virginia State University
302 Curtis Complex
P.O. Box 1000
Institute, WV - 25112 -1000

Section III (Counselor)

OMB No.: 0503-0015

USDA/1890 National Scholars Program Secondary School Report

Legal name in full (Please print)
Please type or print using black ink

Last

First

Middle

To comply with the provisions of the Family Educational Rights and Privacy Act of 1974, a school must
obtain signed authorization before it can release student information for use in this scholarship program.
Permission is hereby given to school officials to release school record and other requested information for
consideration in the scholarship program named above.

Student’s signature

Date

Parent’s or legal guardian’s signature

Date

If you have attended this school less than 2 years, you may copy this form and ask someone from your former
school to also complete a copy for you.
School
Name

City

State

Zip code

Telephone Number

Sections III and IV of this report should be completed and signed by the counselor and teacher.
Note for the counselor: We appreciate the time you are taking to support your student. The student named above is a candidate for
the honor of United States Department of Agriculture/1890 Historically Black Land-Grant Institutions National Scholars Program
To process this application, we need the following: a carefully considered character and ability assessment by a teacher who knows
the student well, a summary of teachers’ judgments of the student, and an official transcript of the student’s secondary school
record. Thorough responses will greatly enhance your student’s candidacy.
This information will be used only in connection with the selection of Scholars and will be seen only by qualified persons involved in the
selection process. Please note, however that only students with a GPA of 3.0(unweighted) on a 4.0 scale and a combined SAT score of
at least 1500 or 1000(math & verbal) or ACT score of at least 21 are eligible for the 1890 Scholars Program.

This form must be returned POSTMARKED NO LATER THAN FEBRUARY 1.

Page | 7

Section III (Counselor)

A.
Name of Counselor
Please type or print using black ink

Last

First

Middle

B.
Are you confident that the student will receive a high school diploma during the current academic year?

Yes

If no, please explain.

C.
Students class rank

How many students in the class?

D.
Student’s cumulative grade point average (unweighted on 4.0 scale)

E.
ACT Composite Score

SAT Combined Score

Secondary School Record

The students’s SAT and/or ACT scores, along with an official secondary school transcript (with seal and signature), including
grades 9 through 12 must be attached. If the official transcript is not provided, the candidate will not be considered for the
scholarship.

Counselor’s signature

Date

This form and the candidate’s transcript must be returned to each 1890 Historically Black Land-Grant Institution of interest.
(See address list.) MUST BE POSTMARKED BY FEBRUARY 1.

Page | 8

Section III (Counselor)

USDA Liaison Officer
Fort Valley State University
Agricultural Research Station
1005 State College Drive
Fort Valley, GA 31030-3298

USDA Liaison Officer
University of Arkansas Pine-Bluff
P.O. Box 4806, UAPB
1200 North University
Pine Bluff, AR 71601-2799

USDA Liaison Officer
Kentucky State University
Cooperative Extn Bldg., Rm 227
400 East Main St
Frankfort, KY – 40601
USDA Liaison Officer
Langston University
School of Agriculture and Applied Sciences
100 Success Dr, Rm V115
Langston, OK 73050
USDA Liaison Officer
Lincoln University
108 Bennett Hall
818 Lee Drive
Jefferson City, MO 65101-0029
USDA Liaison Officer
North Carolina A&T State University
107 B.C. Webb Hall
Greensboro, NC 27411

Page | 9

USDA Liaison Officer
University of Maryland-Eastern Shore
Trigg Hall, Rm 1137
Princess Anne, MD 21853
USDA Liaison Officer
Virginia State University
P.O. Box 9081
L. Douglas Wilder Bldg., Rm 204B
Petersburg, VA 23806
USDA Liaison Officer
West Virginia State University
302 Curtis Complex
P.O. Box 1000
Institute, WV - 25112 -1000

Section IV (Teacher)

OMB No.: 0503-0015

In items C-G, please be concise. Limit your response to the space provided.

A.
Name of teacher
Please type or print using black ink

Last

First

Middle

B.
Length of relationship

C.
Considering this student’s interests, work habits, and life goals, what is your assessment of the chances that the student will
be motivated to take advantage of the opportunities available in college? Please give reasons for your assessment.

D.
What special features are a part of your school’s curriculum (e.g., AP and honors courses, college study,
independent study)? Has the student taken advantage of the most challenging opportunities your school has to
offer?

E.
Describe this student’s strengths and weaknesses.
Strengths:

Weaknesses:

Page | 10

Section IV (Teacher)

F.
Has the student shown exceptional talent or originality in agriculture, food, natural resource sciences and/or other related disciplines?
Yes
No Please explain:

G.
Sometimes special circumstances should be considered when evaluating a student’s achievement records and test scores. If, in your
opinion, this student may have been disadvantaged by any such circumstances, please specify.

Page | 11

Section IV (Teacher)

H
In the spaces below, please summarize comments made by teachers about the student:
1.

Participation in discussion
always involved, often initiates discussion
occasionally participates
seldom participates
not applicable

Personal responsibility
always accepts fully
usually accepts fully
sometimes refuses
often refuses

Involvement in classroom activities
active, usually shows genuine interest
mild, politely attentive
languid, attention often wanders
vacillates greatly
poor understanding

Consideration for others
always considerate of others’ rights
and feelings
usually considerate
sometimes inconsiderate
often inconsiderate

Pursuit of independant study
considerable study and major project(s)
some study and minor project(s)
no evidence of independent study
not applicable

Evenness of performance
even, varies no more than one mark
slightly uneven, often varies one mark
uneven, often varies two marks
erratic, performance fluctuates greatly
inadequate
opportunity
to
observe

Population of the community in which
your school is located
less than 500
500 - 1,500
1,500 - 5,000
5,000 - 25,000
25,000 - 100,000
over 100,000

Critical and questioning attitude
often challenges
occasionally probes
rarely questions
not applicable

Depth of understanding
excellent insight
good understanding
some insight
little insight
not applicable

10. What economic or social conditions
characterize your community and most of
the parents of the children in your school.
rural farming area
industrial small town or city
large, metropolitan area
other

Teacher’s signature

Date

This form and the candidate’s transcript must be returned to each 1890 Historically Black Land‐Grant Institution of interest.
(See address list.) MUST BE POSTMARKED BY FEBRUARY 1

Page | 12

Section IV (Teacher)

Page | 13

Office of the Assistant Secretary for Civil Rights
USDA/1890 Programs
300 7th Street SW, Suite 266, Room 272,
Washington, DC 20024
Telephone Number: (202) 205-5692
Fax Number: (202) 205-2641
Website: http://www.ascr.usda.gov/1890programs.html
Email: [email protected]
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it displays a valid OMB control number.
The valid OMB control number for this information collection is 0503-0015. The time required to complete
this information collection is estimated to average 2.6 to 3 hours per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on
the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation,
and marital or family status. (Not all prohibited bases apply to all programs.)Persons with disabilities who
require alternative means for communication of program information (Braille, large print, audiotape, etc.)
should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD).To file a complaint of
discrimination, write USDA, Director, Office of Civil Rights, 300 7th Street SW, Suite 521, Washington, DC
- 20024 or call (202) 401-0005 or (800) 795-3272.
USDA is an equal opportunity provider and employer.

File Type	application/pdf
File Modified	0000-00-00
File Created	0000-00-00