Scholarship Application - Arizona Nursery Association

A professional trade organization dedicated to the promotion and advancement of the nursery industry for its members and the public they serve.

Fill out the following form completely and once you have completed the form, hit the "Submit" button to send your application to us. A representative will contact you shortly thereafter to confirm your request.

* All fields marked with asterisk are required to submit application. If you do not have information or the field simply does not apply, enter "n/a".

Personal Data:

*First Name:
*Last Name:
*Current Address:
*City, State, Zip Code:
*Permanent Address:
*City, State, Zip Code:
	Check here if permanent address is same as current
*Phone:
*Email Address:
*Age:

*Are any of your relatives involved in horticulture or a closely related field? Yes No

(If yes to above, explain their relationship to you and the field in which they are involved.)

Educational Background:

*1.

Name of school now attending:

Current official (with seal) high school and college transcript for each school attended must be sent to ANA to be eligible for awards. Last high school or college quarter or semester completed must be on transcript. (Note: be sure to contact schools early to allow transcripts to be sent on time.)

*2.

Name of school or continuing education planning to attend:

*A.	Cost per semester at above school OR
	Cost for continuing education program
*B.	Amount of money requested:
*C.	Semester or time frame for which scholarship is requested:**

** If a scholarship award winner cannot use their award in the semester for which the award was granted; the recipient forfeits their scholarship award.

*3.

If currently a student:

*A.	Major Minor or Specialization
*B.	Current year in school (check one): HS Senior
	College: Freshman Sophomore Junior Senior
*C.	How many years in college? Expected date of graduation?
*D.	Total number of college units completed:
	Number of college units currently carrying:
	(Indicate semester or quarter )
*E.	Total number of units completed in major:
	Number of college units currently carrying in major:
	(Indicate semester or quarter )
*F.	Overall college grade point average:
	Grade point average in major:

*4.

If currently a nursery industry employee:

*A.	Currently employed by:
	Number of years:
*B.	Current position or job duties:
*C.	Previous positions in the industry:

*5.

High schools and colleges attended:

*6.

Industry trade schools attended or certification classes completed (include dates):

Activities:

*7.

List any awards, honors and/or scholarships you have received:

College:

High School:

*8.

Activities related to horticulture:

*A.	College:

*B.	High School:

*C.	Community:

*9.

Other activities and offices held (college, high school, community):

Personal References:
Please submit letters of recommendation from any two of the following: Ornamental Horticulture instructor, counselor, present or most recent employer, club/activity advisor, community or church leader. SUBMIT LETTERS OF RECOMMENDATION AND TRANSCRIPTS TO: Arizona Nursery Association 1430 W. Broadway Suite 110 Tempe, AZ 85282 Phone (480) 966-1610 Fax(480) 966-0923
Work Experience:
*10.	List the last four work experiences you have had, whether or not related to horticulture:
	Employer:	Job Title/Duties:	Date:

Educational and Occupational Goals:
*11.	List your educational objectives:

*12.	Other than this scholarship, what funding do you plan to use for your college or continuing education?

*13.	List your occupational goals as they relate to the nursery industry and/or horticulture: