1890 National Scholars Program - High School Application

OMB No.: 0503-0015

TABLE OF CONTENTS

Introduction

2

Overview

3

Instructions

5

Privacy Act Advisory Statement and Release Form

6

Biographical Questionnaire

7

Applicant Checklist

11

Applicant’s Authorization to Release Academic Information

12

High School Guidance Counselor Report

13

High School Teacher Assessment

14

List of 1890 Universities

17

1

OMB No.: 0503-0015

INTRODUCTION
Thank you for your interest in the USDA/1890 National Scholars Program. The USDA/1890 National
Scholars Program was established in 1992 as part of the partnership between the U.S. Department of
Agriculture and the eighteen 1890 Historically Black Land-Grant Universities.
The goal of the USDA/1890 National Scholars Program is to increase the number of minorities studying
agriculture, food, natural resource sciences and other related disciplines. Each year, hundreds of students
apply for the program that provides full tuition, room, board, internships, and full-time employment upon
graduation.
The USDA/1890 National Scholars Program is available to graduating high school seniors that exhibit
leadership and community service and desire to attend one of the eighteen 1890 Historically Black LandGrant Universities. Again, thank you for your interest and best wishes in your pursuit of academic
excellence.
Sincerely,
USDA/1890 National Scholars Program

2

OMB No.: 0503-0015

USDA/1890 National Scholars Program
Overview
The USDA/1890 National Scholars Program is a partnership between of the U.S. Department of Agriculture (USDA) and 1890
Historically Black Land-Grant Universities. The program awards scholarships to students attending one of eighteen 1890
Historically Black Land-Grant Universities, pursuing a bachelor’s degree in agriculture, food, natural resource sciences, and other
related disciplines, and willing to work full-time with the USDA upon graduation. There are eighteen 1890 Historically Black
Land-Grant Universities, including:










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
 Botany
Agricultural Business/Management
 Food Sciences/Technology
Agricultural Economics
 Forestry and Related Sciences
Agricultural Engineering/Mechanics
 Home Economics/Nutrition
Agricultural Production and
 Horticulture
Technology
 Natural Resources Management
Agronomy or Crop Science
 Soil Conservation/Soil Science
Animal Sciences
 Farm and Range Management
Other related disciplines, (e.g., non-medical biological sciences, pre-veterinary
medicine, computer science)

3

OMB No.: 0503-0015

USDA/1890 National Scholars Program
Overview
THE AWARD

The USDA/1890 National Scholars Program scholarship is awarded annually
and must be used at one of the eighteen 1890 Historically Black Land-Grant Institutions. Each
award provides annual tuition, fees, books, room and board, employee benefits, use of a laptop
computer, printer and software while on scholarship, for each of the 4 academic years. The
scholar is required to work in the Student Educational Employment Program during school breaks
(typically during the summer) and agree to 1 (one) year of service with the U.S. Department of
Agriculture for each year of financial support at the completion of the scholar's bachelor degree
program. Each annual scholarship renewal is contingent upon satisfactory performance and
normal progress toward the bachelor’s degree.

WHO SHOULD 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.

GENERAL
ELIGIBILITY

Applicant must:











APPLICATION
DEADLINE

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 cumulative GPA of 3.0 or better (on a 4.0 scale)
Have a combined verbal/math/written score of 1,500 or more on the SAT
(note: 1,000 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 attending one of the eighteen 1890 Land-Grant Universities
Intend to study agriculture, food, natural resource sciences, or other related academic
disciplines
Demonstrate leadership and community service
Submit an official transcript with the school seal and an authorized official's signature
Submit a signed application (original signature only)

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

4

OMB No.: 0503-0015

INSTRUCTIONS
Applicants should read the application materials thoroughly before completing and submitting the application. Only complete
application packages submitted by the application deadline will be considered for the USDA/1890 National Scholars Program
scholarship. To begin the application process, applicants must do the following:






Complete the Privacy Act Advisory Statement and Release Form
Complete Biographical Questionnaire
Sign and Date the application
Obtain a signature from a parent or guardian, if the applicant is under 18 years old.
Mail the application by the postmark deadline of February 1.

Applicants are responsible for ensuring that the high school counselor and high school teacher complete their report (pages
13) and assessment (pages 14) and submit them by the application deadline. All materials must be originals, with original
signatures and seals/stamps. Photocopied signatures and transcripts will not be considered for the USDA/1890 National
Scholars Program scholarship.
Please note: The selection of scholarship recipients will be influenced by the completeness, neatness, and legibility of replies.
The application may be filled out electronically by typing the required information or by printing clearly using black ink.

5

OMB No.: 0503-0015

Privacy Act
Advisory Statement

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

6

OMB No.: 0503-0015

Candidate’s Biographical Questionnaire
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.

A.

Biographical Information

(Please print)
Legal name in full _____________________________
Last

Permanent home address

___________________ _______________
First
Middle

F

M

____________________________ _____________________ _____________ ________
Number and street
City/Town
State
Zip Code

Telephone

Age

Are you a U.S. citizen?

B.

Sex:

Yes

No

e-mail address:

Education

1. Name of high school now attending

City

Telephone

State

GPA (on a 4.0, unweighted scale)

Zip code

ACT Composite Score ______ SAT (math and verbal) ________ (Combined) ________

Note: Grade point average and standardized test scores should match supporting documentation submitted by counselor. Only applicants
meeting minimum GPA criteria and standardized test scores will be considered for the USDA/1890 National Scholars Program scholarship.
Please do not submit an application if you do not meet the criteria.
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)

Dates of Attendance

7

OMB No.: 0503-0015

Candidate’s Biographical Questionnaire
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

Dates of Attendance

(city and state

Hours per
week

4. Name of the 1890 University to which you are applying _________________________________________________________
Note: Applicants applying to more than one 1890 University must submit separate applications and send to each school of choice.
5. What course of study (major) will you pursue?

1

st

Choice _________________________________________

2

nd

Choice _________________________________________

Other Related Discipline/unlisted major (please identify)
Note: All academic disciplines may not be available at each 1890 University. Check the university’s academic offerings before applying.

6. Have you made career decisions related to agriculture, food, natural resources sciences, or other related disciplines?

Yes

No

If Yes, explain: __________________________________________________________________________

7. Do you plan to go to graduate or professional school?

C.

Yes

No If YES, field of study ______________________________

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
Dates

Offices Held

Special Awards, Honors or Recognition

8

OMB No.: 0503-0015

Candidate’s Biographical Questionnaire
2. List volunteer services and jobs you have held in the past 4 years (including summer employment).

Volunteer services or jobs

Name of organization or
employer

Dates of service
or employment

Hours per
week

Special awards

Note: Please be concise and limit your responses 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?

2. What do you do for relaxation and fun?

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

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

9

OMB No.: 0503-0015

Candidate’s Biographical Questionnaire
E.

Candidate’s Self Assessment

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

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

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,
and that a false statement could eliminate me from consideration for this scholarship.

Applicant’s Signature

Date

This form must be returned to each 1890 University(s) of your choice.
MUST BE POSTMARKED BY FEBRUARY 1

How did you hear about the USDA/1890 National Scholars Program Scholarship?
College fair(s)
Informational Session
Public Service Announcement
Direct Mail/e-mail
USDA Employee
Church or place of worship
Website(s)
Other

(select all that apply)

Name of event(s)
Location
Stations
Source of communication
Name of employee(s)
Name of Facility
Name of website(s)

10

OMB No.: 0503-0015

USDA/1890 National Scholars Application Checklist
1.

I have read the eligibility requirements and meet all eligibility criteria.

2.

I am submitting an original application and transcript to each 1890 University of interest
(see addresses on page 17 of this application)

3.

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

4.

I have read and filled out Candidate’s Biographical Information section. I understand that
the application must be postmarked no later than February 1, in order to meet the
eligibility requirements.

5.

6.

I have given the Secondary School Report to my counselor and teacher to fill out. I
understand these pages must be mailed and postmarked no later than February 1.
Further, I have explained to my counselor and teacher the need to have all official
transcripts with a seal and signature enclosed with this response and sent to the
institution’s USDA Program Manager where I have selected to attend using the list on
page 27 of this application that I provided to them.
I have signed and dated the application (original signature only)

11

OMB No.: 0503-0015

USDA/1890 National Scholars Program Scholarship
Applicant’s Authorization to Release Academic Information
Applicant’s Legal, Full Name _______________________ _____________________ ____________________ _______
Last
First
Middle
Suffix

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 _______________

Parents’ or Legal Guardians’ Signature ___________________________________

Date ________________

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

School Name

City

State

Zip Code

Phone Number

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 National Scholars Program scholarship. To process this application, we need the following:


An official transcript of the student’s secondary school record with a seal and signature by an authorized school official

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
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. Please delete all personal identifiable information, such as complete social security numbers and complete dates of birth from any
supporting documentations.

For questions or more information about the USDA/1890 National Scholars Program Scholarship, please contact us at [email protected] or
202-205-4307.

Duplicate form as necessary

12

OMB No.: 0503-0015

USDA/1890 National Scholars Program Scholarship
Secondary School Report
High School Guidance Counselor
A.
Please type or print using black ink

Name of Counselor
Last

First

MI

Suffix

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

Yes

No

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)

Do not enter GPA on a scale of 0-100

E.
ACT Composite Score
(attach a copy of test scores)

SAT Score (combined)

SAT Score (math and verbal) _________

F.
Secondary School Record
The applicant’s SAT and/or ACT scores, along with an official secondary school transcript (with seal and signature by an authorized official),
including grades 9 through 12 must be attached to this section of the application. 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 Land-Grant University(s) (see address list) of interest (confirm with the
applicant) and MUST BE POSTMARKED BY FEBRUARY 1.

13

OMB No.: 0503-0015

USDA/1890 National Scholars Program Scholarship
Secondary School Report
School Teacher Assessment
The application for the USDA/1890 National Scholars program scholarship requires a carefully considered character and ability assessment by a
teacher who knows the student well, including a summary of other teachers’ judgments of the student.

A.
Please type or print using black ink

Name of Teacher
Last

First

MI

Suffix

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?

14

OMB No.: 0503-0015

School Teacher Assessment
E.
Has the student shown exceptional talent or originality in agriculture, food, natural resource sciences, and/or other related disciplines?
Yes

No Please Explain:

F.
Describe this student’s strengths and weaknesses.

Strengths

Weaknesses:

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.

15

OMB No.: 0503-0015

School Teacher Assessment
H.
In the spaces below, please summarize comments made by teachers about the student:
(Please select the best answer)
1. Participation in discussion:

2. Involvement in classroom activities:

always involved, often initiates discussion

occasionally participates

seldom participates

not applicable

active, usually shows genuine interest

mild, politely attentive

languid, attention often wanders

vacillates greatly

poor understanding
3. Pursuit of independent study:

4. Evenness of performance:

considerable study and major project(s)

some study and minor project(s)

no evidence of independent study

not applicable

even, varies no more than one mark

slightly uneven

uneven, often varies two marks

erratic, fluctuates greatly

inadequate opportunity to observe
5. Critical and questioning attitude:

6. Depth of understanding:

often challenges

occasionally probes

rarely questions

not applicable

excellent insight

good understanding

some insight

little insight

not applicable
7. Personal responsibility:

8. Consideration for others:

always accepts fully

usually accepts fully

sometimes refuses

often refuses

always considerate of others’ rights and feelings

usually considerate

sometimes inconsiderate

often inconsiderate

9. 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

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 must be returned to each 1890 Land-Grant University(s) (see address list) of interest (confirm with the applicant) and MUST BE
POSTMARKED BY FEBRUARY 1.

16

OMB No.: 0503-0015

1890 Universities
Attn: USDA Program Manager
Alabama A&M University
Dawson Extension Bldg., Room 300 or
Post Office Box 1087
Normal, AL 35762

Attn: USDA Program Manager
Prairie View A&M University
E. E. O'Banion
P. O. Box 2736
Cooperative Agricultural Research Center
Prairie View, TX 77446

Attn: USDA Program Manager
Alcorn State University
1000 ASU Drive, Room 1139
104 Agriculture Science Building.
Lorman, MS 39096

Attn: USDA Program Manager
South Carolina State University
300 College Avenue, N.E.
P.O. Box 7246
Orangeburg, SC 29117

Attn: USDA Program Manager
Delaware State University
College of Agriculture & Related Sciences
1200 North Dupont Highway
Baker Building Annex, Room 102
Dover, DE 19901

Attn: USDA Program Manager
Southern University and A&M College
College of Agriculture, Family & Consumer Sciences
Fisher Hall, Room 102
Baton Rouge, LA 70813

Attn: USDA Program Manager
Florida A&M University
1740 South Martin L. King Jr., Boulevard
Room 217, S. Perry-Paige Building.
Tallahassee, FL 32307-4100

Attn: USDA Program Manager
Tennessee State University
3500 John Merritt Boulevard.
Ag Science Dept., Room 112
P.O. Box 9629
Nashville, TN 37209-1561

Attn: USDA Program Manager
Fort Valley State University
USDA Program Manager
1005 State University Drive
Pettigrew Center, Room 244
Fort Valley, GA 31030

Attn: USDA Program Manager
Tuskegee University
College of Agricultural,
Environmental and Natural Sciences
Campbell Hall, Room 103
Tuskegee, AL 36088

Attn: USDA Program Manager
Kentucky State University
Cooperative Extension Building, Room 227
400 East Main Street
Frankfort, KY 40601

Attn: USDA Program Manager
University of Arkansas Pine Bluff
1200 North University
Mail Slot: 4806
Pine Bluff, AR 71611-2799

Attn: USDA Program Manager
Langston University
School of Agriculture and Applied Sciences
100 Success Drive, Room V115
P.O. Box 846
Langston, OK 73050

Attn: USDA Program Manager
University of Maryland Eastern Shore
Trigg Hall, Room 1137
Princess Anne, MD 21853

Attn: USDA Program Manager
Lincoln University
108 Bennett Hall
818 Lee Drive.
Jefferson City, MO 65101

Attn: USDA Program Manager
Virginia State University
L. Douglas Wilder Building, Room 204B
P.O. Box 9081
Petersburg, VA 23806

Attn: USDA Program Manager
North Carolina A&T University
1601 East Market Street
107 B.C. Webb Hall
Greensboro, NC 27411

Attn: USDA Program Manager
West Virginia State University
302 Curtis R&E Complex
P.O. Box 1000
Institute, WV 25112-1000
Duplicate form as necessary

17

OMB No.: 0503-0015

Application Deadline

February 1
Office of the Assistant Secretary for Administration
Office of Advocacy and Outreach
USDA/1890 Programs
1400 Independence Ave., SW, STOP 9821
Washington, DC 20250
Telephone Number: (202) 205-4307
Fax Number: (202) 720-7136
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.

18