PCID Scholarship Application Form – Norfolk Botanical Garden

Name

First Name

Last Name

Email

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Phone

Address

Street Address

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City

State/Province

Zip Code

Postal/Zip Code

Are you the first person in your family to attend college?

Yes

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Select from Menu Your Completed Education Year-to-Date

Name of Educational Institution

City, State

Dates: To/From

Course of Study

Degree Received

Educational Experiences (workshops, certificated, etc.)

Current or Accepted Educational Institution, Field of Study, Length of Program

Eligible applicants must be accepted or currently enrolled in an educational program dedicated to a field of study in a green industry or related field. Please identify the educational institution you will be attending and the length of the program and field of study you will be pursuing.

Explain why this area is of interest to you.

Extracurricular Activities

Please list or describe extracurricular activities, awards, community service, special training, recognitions, or positions.

Response to Discussion Topic

Provide a response to ONE (1) of the following discussion topics. 1. Why do you consider yourself a Green Leader or committed to a field of study in the Green Industry? 2. Describe a situation or personal hardship which required tenacity and had a significant impact on your life. 3. How does the story of the NBG Original Gardeners inspire you or relate to your personal life experiences? Please note, responses should not exceed 500 words.

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Applicant Signature

Date:

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