Eligible applicants must meet all of the following criteria:

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1 The Clark County Community Foundation, Inc. (CCCF) has established the Clark County Community Scholarship Fund for the benefit of the students from Clark County Wisconsin, and who meet the following qualifications. In 2016, the Clark County Community Scholarship Fund is awarding at least three (3) $ scholarships to eligible Clark County, WI high school graduates. Eligible applicants must meet all of the following criteria: 1. The Clark County Community Scholarship Fund program is available to any 2016 high school graduate, whose primary residence (address) is located within Clark County, Wisconsin; and 2. Who will graduate with a GPA of at least 2.00 (as of the scholarship application date); and 3. Who is graduating from one of the following School Districts; and Abbotsford Loyal Pittsville Alma-Center Marshfield Spencer Colby Neillsville Stanley-Boyd Granton Osseo-Fairchild Thorp Greenwood Owen-Withee Or other DPI accredited Home School 4. Who complies with the admissions requirements for full-time student status, and has been accepted for enrollment (or is in the enrollment process) at an accredited university or technical school pursuing an associate or bachelor degree. To Apply: 1. Complete and submit the attached Clark County Community Scholarship Fund Application. [(pages 2-5) attaching any additional information as required or as necessary to complete the Application in its entirety.] 2. Include two letters of reference. [One from someone who knows you academically and one from someone who knows you personally.] 3. Mail the application by March 31, 2016 to: SCHOLARSHIP APPLICATIONS Clark County Community Foundation, Inc. PO Box 116 Loyal, WI Successful applicants will be notified of their scholarship award by May 6, Checks will be mailed to the scholarship winners upon receipt of proof of his/her enrollment to the college, or technical college, of their choice, for the FALL SEMESTER of Scholarship awards are not retroactive and may not be credited to semesters already completed. Revised 1/26/ of 5

2 (Please print or type Attach additional pages and information as necessary.) (If attaching additional pages, please answer each question, separately, and in the order shown on this application. ) Applicant s Name: Permanent Address: Street City/State/Zip Contact Phone # Applicant Date of Birth / / High School (check school graduating from:) Abbotsford High School Colby High School Greenwood High School Marshfield High School Osseo Fairchild High School Pittsville High School Stanley Boyd High School Alma Center Lincoln High School Granton High School Loyal High School Neillsville High School Owen Withee High School Spencer High School Thorp High School Other / Home School (describe) Date of High School Graduation: Most Recent GPA (Signature of School Guidance Counselor / Other) 1. Where are you planning to enroll as a full-time student in the fall? 2. In which area of study do you plan to receive Bachelor / Associate degree? Revised 1/26/ of 5

3 3. Why have you chosen this area or field of coursework to study? 4. Please list any Community Service efforts and/or other Non-School related activities you have been involved in during your years in High School. [i.e. 4 H, church, employment, Girl Scouts, Boy Scouts, Club sports, or other activities] Community Activity Involved In Describe Years Participated 9th 10th 11th 12th 5. Please list School related activities, and years that you participated in each activity. [i.e. Sports, music, organizations, plays, musicals, leadership roles, etc.] School Activity Involved In Describe (Position / Role) Years Participated 9th 10th 11th 12th Revised 1/26/ of 5

4 6. Write a short paragraph explaining why you are applying for this scholarship. 7. Describe how living in a rural community and graduating from your High School has impacted you, your education (to date) and your choice(s) for further education after graduation. 8. Describe a significant experience or event from which you learned a lesson, or that has had an impact on your values or opinions, while living in Clark County Wisconsin. 9. Please include any factors which might limit your ability to attend a university, college, or technical college, or would influence your financial capabilities to do so ( i.e. circumstance such as illness, recent changes in financial support, other siblings in college, major financial liabilities, etc.) Revised 1/26/ of 5

5 10. Include two letters of reference, and explain how each reference knows you. Provide one reference from someone who knows you academically; and Provide a second reference from someone who knows you personally. (Second reference may be a retired / former teacher who knows you personally) Mail completed Scholarship Application by March 31, 2016 to: SCHOLARSHIP APPLICATIONS Clark County Community Foundation, Inc. PO Box 116 Loyal, WI information@clarkccf.org Phone: Revised 1/26/ of 5