Download:
pdf |
pdf
United States Department of Agriculture
USDA/1890 National Scholars Program
APPLICATION
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 1890 Historically Black
Land-Grant 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 the eighteen 1890 Historically Black Land-Grant Universities. The program awards scholarships
to students attending one of the 1890 Historically Black Land-Grant Universities, pursuing a bachelor degree in
agriculture, food, natural resource sciences, or related academic disciplines, and willing to work full-time with
the USDA upon graduation. The eighteen 1890 Historically Black Land-Grant Universities are as follows:
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
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, and natural
resource science or other related disciplines
To offer career opportunities to USDA/1890 National Scholars at the U.S.
Department of Agriculture
The USDA/1890 National Scholars Program offers scholarships to U.S. citizens that are
seeking a bachelor 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
Food Sciences/Technology
3
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
Forestry and Related Sciences
Home Economics/Nutrition
Horticulture
Natural Resources Management
Soil Conservation/Soil Science
Farm and Range Management
Other related disciplines, (e.g. nonmedical biological sciences, preveterinary medicine, computer
science)
OMB No.: 0503-0015
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 SHOULD
APPLY
Applicants must be U.S. citizens that are high school seniors completing a high school
Diploma or a G.E.D. Certificate and entering the first year of college pursuing a
bachelor’s degree.
GENERAL
ELIGIBILITY
Applicant must:
APPLICATION
DEADLINE
Be a U.S. citizen
Be a graduating high school senior or 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;
Must have applied for admission to the 1890 Land-Grant University you plan to
attend
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 complete 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 applicants under 18 years old
Obtain High School Counselor’s report in a sealed envelope and submit with your application
package
Obtain High School Teacher’s report in a sealed envelope and submit with your application
package
Submit all documents in one package at the time of application
Mail the application by the postmark deadline of February 1
Applicants are responsible for obtaining the reports of the High School Counselor (page 14) and the High
School Teacher (page 15). These Assessment Reports should be in a sealed envelope and included with
the Application package. 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 by typing the required information or by printing
clearly using black or blue 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 this 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 the 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 LandGrant 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: __________________________________________________
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
First
Middle
Sex: F
M
Permanent Home Address: ________________________________________________________________________
Street
City/Town
State
Zip Code
Telephone: (Home) ____________________________
(Cell)
Age: ___________
____________________________
Are you a U.S. Citizen?
Yes
No
Email Address: ______________________________________
B. Education
1.
Name of High School currently attending: _______________________________________________________
Address: ________________________________________________________________________________________
Street
City/Town
State
Zip Code
Telephone: ___________________
GPA (on a 4.0 unweighted scale)______ 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
Address
7
Dates of Attendance
OMB No.: 0503-0015
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
Address
Dates of Attendance
Hours Per Week
4.
Name of the 1890 University to which you are applying: ______________________________________________________
5.
If applying to multiple 1890 Universities, please list in order of preference (i.e. 1-Most Preferred, 3-Least Preferred)
1.
____________________________ 2. ______________________________ 3. _______________________________
Note: Applicants applying to more than one 1890 University must submit separate applications and send to each school of
choice.
6.
What course of study (major) will pursue?
1st Choice: ____________________________________
2nd Choice: _______________________________________
Other Related Discipline/Unlisted Major (Please Identify): ___________________________________________________
Note: All academic disciplines may not be at each 1890 University. Check the University’s academic offerings before applying.
7.
Have you made career decisions related to agriculture, food, natural resource sciences, or related disciplines?
Yes
No
If Yes, please explain: _________________________________________________________________
C. 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
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. Candidates Self-Assessment
1. Describe a recent experience that has given you a sense of satisfaction or pride. Explain why you were not satisfied or proud.
2. Briefly discuss why you want to study agricultural, food, natural resource sciences or a 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 are true and accurate to the best of my knowledge, and a
false statement could eliminate me from consideration for this scholar
_________________________________________________
Applicant’s Signature
________________________________
Date
This form must be returned to each 1890 University(s) of your choice and
MUST BE POSTMARKED BY FEBRUARY 1
How did you hear about the USDA/1890 National Scholars Program Scholarship?
College fair(s)
Name of event(s)
______________________________________________
Informational Session
Location
______________________________________________
Public Service Announcement
Stations
______________________________________________
Direct Mail/e-mail
Source of communication
______________________________________________
USDA Employee
Name of employee(s)
______________________________________________
Church or place of worship
Name of Facility
______________________________________________
Website(s)
Name of website(s)
______________________________________________
Other
________________________________________________________________________
10
(select all that apply)
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
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 _________________________________________________________________________________________
Address ______________________________________________________________________________________________
_________________________________________
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 and SAT and/or ACT scores 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) 260-8415.
Duplicate form as necessary
11
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
Address ________________________________________________________________ Phone ____________________
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.
Student’s class rank _________________
How many students are in the class? ______________________
D.
Students cumulative grade point average (unweighted on 4.0 scale)
__________ Do not enter GPA on a scale of 0-100
E.
ACT Composite Score ___________ 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 and
SAT and/or ACT scores are not provided, the candidate will not be considered for the scholarship.
Counselor’s Signature _______________________________________________________ Date ______________________
This form and the candidate’s transcript and SAT and/or ACT scores must be returned with the student’s application package for
submission to each 1890 Land-Grant University(s) of interest and be POSTMARKED BY FEBRUARY 1.
12
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
Address ________________________________________________________________ Phone ____________________
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?
13
OMB No.: 0503-0015
School Teacher Assessment
E.
Has the student shown exceptional talent or originally 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 specials 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.
14
OMB No.: 0503-0015
School Teacher Assessment
H.
In the spaces below, please summarize comments made by teachers about the student:
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 gently
poor understanding
3. Pursuit of independent study:
4. Evenness of performance:
considerable study and major project(s)
some study and minor projects(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 understanding
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 the student for inclusion in their application package for submission to each 1890 University
and be POSTMARKED NO LATER THAN FEBRUARY 1.
15
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 16 of this application).
3.
I have applied for admission to each 1890 Historically Black Land-Grant Institution
of interest.
4.
I have read and completed the Candidate’s Biographical Information section.
5.
I have included the Secondary School Report from my High School Counselor and
explained the need to have all official transcripts with a seal and signature and
SAT and/or ACT scores enclosed with this response.
6.
I have included the School Teacher Assessment completed and signed by my
teacher.
7.
I have signed and dated the application (original signature only).
8.
I understand that the application package must be postmarked no later than
February 1 for consideration for the USDA/1890 Scholars Programs Scholarship.
16
OMB No.: 0503-0015
1890 Universities
Attn: USDA/1890 Program Liaison
Alabama A&M University
Dawson Extension Bldg., Room 300 or
Post Office Box 1087
Normal, AL 35762
Attn: USDA/1890 Program Liaison
Prairie View A&M University
E. E. O'Banion CARC Building, Room 119
P. O. Box 2736
Prairie View, TX 77446
Attn: USDA/1890 Program Liaison
Alcorn State University
1000 ASU Drive, Room 1139
Agriculture Science Building Rm. 104
Lorman, MS 39096
Attn: USDA/1890 Program Liaison
South Carolina State University
300 College Avenue, N.E.
P.O. Box 7246
Orangeburg, SC 29117
Attn: USDA/1890 Program Liaison
Delaware State University
College of Agriculture & Related Sciences
1200 North Dupont Highway
Baker Building Annex, Room 102
Dover, DE 19901
Attn: USDA/1890 Program Liaison
Southern University and A&M College
College of Agriculture, Family & Consumer Sciences
Fisher Hall, Room 102
Baton Rouge, LA 70813
Attn: USDA/1890 Program Liaison
Florida A&M University
1740 South Martin L. King Jr., Boulevard
Room 217, S. Perry-Paige Building.
Tallahassee, FL 32307-4100
Attn: USDA/1890 Program Liaison
Tennessee State University
3500 John Merritt Boulevard.
Ag Science Dept., Room 112
P.O. Box 9629
Nashville, TN 37209-1561
Attn: USDA/1890 Program Liaison
Fort Valley State University
USDA/1890 Program Liaison
1005 State University Drive
Pettigrew Center, Room 244
Fort Valley, GA 31030
Attn: USDA/1890 Program Liaison
Tuskegee University
College of Agricultural,
Environmental and Natural Sciences
Campbell Hall, Room 103
Tuskegee, AL 36088
Attn: USDA/1890 Program Liaison
Kentucky State University
Cooperative Extension Building, Room 221
400 East Main Street
Frankfort, KY 40601
Attn: USDA/1890 Program Liaison
University of Arkansas Pine Bluff
1200 North University
Mail Slot: 4806
Pine Bluff, AR 71611-2799
Attn: USDA/1890 Program Liaison
Langston University
School of Agriculture and Applied Sciences
100 Success Drive, Room V115
P.O. Box 846
Langston, OK 73050
Attn: USDA/1890 Program Liaison
University of Maryland Eastern Shore
Trigg Hall, Room 1137
Princess Anne, MD 21853
Attn: USDA/1890 Program Liaison
Lincoln University
108 Bennett Hall
818 Lee Drive.
Jefferson City, MO 65101
Attn: USDA/1890 Program Liaison
Virginia State University
P.O. Box 9416
Carter G. Woodson Avenue
Owens Hall, Room 101C
Petersburg, VA 23806
Attn: USDA/1890 Program Liaison
North Carolina A&T University
1601 East Market Street
107 B.C. Webb Hall
Greensboro, NC 27411
Attn: USDA/1890 Program Liaison
West Virginia State University
302 Curtis R&E Complex
P.O. Box 1000
Institute, WV 25112-1000
17
OMB No.: 0503-0015
Application Must Be Postmarked by
February 1
For all questions, please contact:
Office of the Assistant Secretary for Administration
Office of Advocacy and Outreach
USDA/1890 Programs
1400 Independence Ave., S.W., Stop 9821
Washington, DC 20250
Telephone Number: (202) 260-8415
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 martial 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,
th
300 7 Street S.W., suite 521, Washington, DC 20024 or call (202) 401-0005 or (800) 795-3272.
USDA is an equal opportunity provider and employer
18
| File Type | application/pdf |
| Author | USDA |
| File Modified | 2011-08-09 |
| File Created | 2011-08-09 |