Michigan 4-H Foundation » 4-H International Travel Scholarship form

Michigan 4-H Outbound International Travel Scholarship Application

Deadline to apply: February 1

SECTION 1

Name*

Gender*

Male
Female

County of 4-H membership*

4-H Club or Group*

Address*

Mailing Address City State / Province / Region ZIP / Postal Code

Home Phone No

Cell

Email*

Age*

Date of Birth*

*

Current Grade in School	School Attending

Host Country*

Select the country to which you are traveling:

SECTION 2

1. Why do you want to travel to the country you have selected for your summer exchange experience?*

2. Exchange programs are part of the 4-H Leadership and Civic Engagement programs. Please explain how you have been involved in leadership, citizenship and/or global and cultural education activities in 4-H, school, your community, or other ways.*

3. If you were asked to develop a photo story or video about the community/town/city where you live, please list 15 different things you would include in your presentation.*

4. What cultural project will you share with your host family and hosting organization? The cultural project should focus on an aspect of American culture that is important to you. Example: bake or cook an American dish or treat, demonstrate a skill, teach a game or song or make a craft.*

SECTION 3

*

I understand that if I am awarded a scholarship I will complete all the requirements stated, by the deadline given. Any participant that fails to fulfill the requirements in this contract will be responsible for repaying the entire scholarship amount.

4-H International Travel Scholarship form

Michigan 4-H Outbound International Travel Scholarship Application

SECTION 1

SECTION 2

SECTION 3

Note: All travel scholarship award applications must be submitted by February 1.