Scholarship Form - Westlands Water District

Scholarship Application — CREATE NEW FORM WHEN NEEDED

To be considered for the Westlands Water District High School Scholarship please submit all of the following documents:

A completed form (which can be found below).

An essay written by the applicant that is between 350-550 words on one of the three topics listed below. The essay should be typed, double spaced, 12 point Times New Roman font. All essays will be judged based on content and grammar.

Explain how agiculture has affected your life.
Explain how Westlands Water District has affected you and your family.
Explain the importance of agricultural water to California and the west side of the San Joaquin Valley.

A copy of the applicant’s most recent high school transcripts. Unofficial transcripts are accepted.

A copy of the applicant’s acceptance letter from the accredited post-secondary school which the applicant plans to attend. If the letter has yet to arrive it can be provided upon award notification, prior to a check being issued.

Two reference letters, written by non-relatives. The letters must be signed and include the reference’s contact information.

Name(Required)

First Last

Overall GPA(Required)

Age

Address(Required)

Street Address Address Line 2 City State ZIP Code

Do you have a different mailing address?(Required)

Yes

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone(Required)

Email(Required)

Planned Field of Study/Major(Required)

Name of Educational Institution(Required)

Career Goals(Required)

Extra Curricular Activities(Required)

If none write “not applicable”

Leadership Experience(Required)

If none write “not applicable”

Honors and Awards(Required)

If none write “not applicable”

Please list any other information about yourself and your family that you feel will assist us in judging your application (Military affiliation, hobbies or interests, etc.)

Uploads

Below are fields to upload the additional required documents as listed at the top of the form.

Please note if the acceptance letter has yet to arrive it can be provided upon award notification, prior to a check being issued.

Essay(Required)

Max. file size: 100 MB.

High School Transcripts(Required)

Max. file size: 100 MB.

Acceptance Letter(Required)

Max. file size: 100 MB.

Reference Letter #1(Required)

Max. file size: 100 MB.

Reference Letter #2(Required)

Max. file size: 100 MB.

You have entered your age as under 18, please be sure to have a parent or guardian sign below.

To the best of my knowledge, the information in this application is true and correct.

I, the undersigned as the applicant (if over 18 years of age at the time of signing) or parent/guardian of the applicant, do hereby authorize Westlands Water District’s Public Affairs Office to use the name, image and likeness of the applicant and information contained within this application in any press communications related to the announcement of the scholarship winners following the scholarship presentation; unless within five (5) days of the notification of the scholarship award, you or the applicant notifies the Public Affairs Office in writing otherwise.

Signature of Applicant (if over 18) or Parent/Guardian Signature(Required)

Date

Applicant (if over 18) or Parent/Guardian Name

First Last

Legal Consent(Required)

Consumer Disclosure Regarding Conducting Business Electronically, Signing Documents Electronically, and Receiving Electronic Notices and Disclosures

Please read the information below, carefully, as it concerns your rights. eSignatures are an efficient way to execute an agreement with the same legal force and effect of a handwritten or “wet ink” signature. By signing this document you are agreeing that you have reviewed this Consumer Disclosure and consent and intend to transact business electronically; to use electronic signatures instead of wet ink signatures and paper documents, and to receive notices and disclosures electronically.

You are not required to sign documents electronically or to receive notices and disclosures electronically. If you prefer not to transact business electronically, you may request paper copies from the “sending party” and withdraw your consent at any time, as described below.

Scope of Consent
By utilizing this Service, you agree to receive electronic signature documents with all related and identified documents, notices, and disclosures provided during your relationship with the “sending party.” You may withdraw your consent, at any time, by following the procedures outlined below.

Paper Copies
You are not required to sign documents electronically, or receive notices or disclosures electronically, and may request paper copies of documents or disclosures, if you prefer. You also have the ability to download and print any signed or unsigned documents sent to you through the electronic signature service. We may also email you a copy of all documents you sign using the electronic signature service. If you wish to receive paper copies instead of electronic documents you may close this web browser and request paper copies from the “sending party” by following the procedures outlined below. The “sending party” may apply a charge for additional expenses incurred by printing and mailing paper copies.

Withdrawal of Consent
You may withdraw your consent to receive electronic documents, notices or disclosures at any time. In order to withdraw consent you must notify the “sending party” that you wish to withdraw your consent to transact business electronically and to provide your future documents, notices, and disclosures in paper format. If at any time, after withdrawing your consent you choose to use our electronic signature system your use of this Service will, once again, evidence your consent to receive documents, notices, and disclosures, electronically. You may withdraw your consent to receive electronic notices and disclosures or execute an electronic signature by following the procedures described below.

Withdrawing your consent, requesting a paper copy, or updating your contact information
You always have the ability to download and print any documents sent to you through our electronic signature system. To withdraw your consent to conduct business electronically, sign documents electronically, and receive documents, notices, or disclosures electronically, please contact the “sending party” directly; by telephone, by email (sent to the “sending party” with any of the topics outlined below stated in the subject line of your email) or by postal mail to their mailing address specified to receive such notices.

“Withdrawal of Consent To Transact Business Electronically” To allow the “sending party” to identify and facilitate your withdrawal of consent to transact business electronically, please provide your name, email address, the date on which you are withdrawing your consent, your telephone number and mailing address.

“Requesting A Paper Copy” To allow the “sending party” to identify you to provide a paper copy of the document requiring your signature, the notice, or disclosure, please provide the sending party with your name, email address, mailing address, telephone number, and name of the document of which you are requesting a paper copy .

“Update Your Contact Information” To allow the “sending party” to identify you in order to update your contact information, please provide them with your name, email address, mailing address, and telephone number.

The “sending party” will inform you of any fees related to costs for printing and mailing paper copies or your withdrawal consent to transact business electronically.

I agree to the terms and conditions.