Kauai County Farm Bureau - local produce

HTFFA Scholarship Application

First Name: Last Name:
Social Security #:
Mailing Address:
City:     State:     Zip:
Telephone: Email:
Date of Birth: Place of Birth:
Current School: GPA:
Father / Guardian: Occupation:
Mother / Guardian: Occupation:
Total Family Gross Income: (Include all members of the family) for the most recent tax year:

Why do you feel that you deserve this Scholarship?

Please describe your involvement in the following areas, including any awards, special acknowledgments, etc.: academic, community service, sports, clubs, and organizations, hobbies/special interests, job/work experience:

  1. I do hereby certify that the information provided in this application was complied and written solely by the undersigned and that the data is true and correct as of this date.
  2. I consent to the review and release of this application to the appropriate persons in HTFFA and understand that HTFFA requires my Social Security Number for its records.
  3. I agree and grant permission to HTFFA for the use of my name and other information for the purpose of promotion, advertising, recognition and/or news releases including publications, without promise of favor or payment. Documents received will be used solely by HTFFA.

Reminder: to complete your application, you must submit three (3) letters of recommendation and a current official transcript to HTFFA, PO Box 2015, Kapaa, HI 96746.