Dallas County Iowa Republican Party Scholarship Application

_____________________________________________________________ Last Name First Name Middle Initial _____________________________________________________________ Address _____________________________________________________________ City State Zip _____________________________________________________________ Home Phone Cell Phone Email address _________________________________________________ Date of Birth __________________________________________________ School Name/Home School _______________________________________ School Activities including political, class, and school offices held: Name of Organization

Position

Year

_____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________

Participation in activities (campaigns, internships, etc...,) that supports the Republican Party (attach extra if needed): _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Extracurricular Activities: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Are you 18? _____

If yes, are you registered to vote? __________

College(s) / Trade School(s) applied to: _____________________________________________________________ _____________________________________________________________ College(s) / Trade School(s) accepted for 2017 school year: _____________________________________________________________ _____________________________________________________________

Desired Major? _____________________________________________________________

Requirements: 1. Must be a Dallas County Resident. 2. Must be graduating & attending a college or trade school in the 2017/2018 school year. 3. Must attach a brief letter of recommendation from an adult (nonrelative) who can attest to your character and interests. 4. Must show through application: extracurricular actives that show service to the community. 5. Must complete essays per guidelines below. 6. If awarded scholarship, winning applicant agrees to allow essay answers, or segments of essay answers, to be published.

Essay: (Please answer both questions & attach to application) 1. What do you see as being the core values of the Republican Party, and how do you see those values working to improve the future of our country? (250 word minimum) 2. Imagine you are the elected Representative of your hometown, or are working on the campaign or staff of an elected Representative. What issues would you work to address, and how would you strive to enact conservative policies in your local area? Lay out a plan of how you would implement your Republican ideals. (400 word minimum) *I verify that the information above is true and accurate to the best of my knowledge. Further, as an applicant, I agree to the terms of the requirements.

Signature ________________________________ Date_________

All Applications are due by May 31, 2017.

Dallas County Republican Party 2017 Scholarship Award Members of the Dallas County Republican Central Committee are offering a scholarship, in the amount of $500.00, to a Dallas County, IA graduating senior. This scholarship is designed to provide financial support to a graduate attending college or a trade school who is involved with the Republican Party. The scholarship is based on essay content, with special consideration given to applicants with a track record of contributing positively to local government and/or campaign activities that are dedicated to the principles of the Republican Party.

Mail to: Dallas County Republican Party Attn: 2017 Scholarship PO Box 1015, Waukee, Iowa 50263

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Email to: [email protected]