IMEF Scholarship Program Application Form
Deadline for Submission: March 1, 2010
Applicant’s Name
Email Address
Social Security Number
Current Address
Are you a U.S. citizen? Yes No If no, Country Afghanistan Albania Algeria Andorra Angola Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Basutoland Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bophuthatswana Borneo Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burma Burundi Cambodia Cameroon Canada Canal Zone Canary Islands Caymen Islands Channel Island Chile Colombia Cook Island Costa Rica Croatia Cuba Curacao Cwth. Ind. St. Cyprus Czech Republic Dahomey Denmark Dominican Republic Ecuador Egypt El Salvador England Estonia Ethiopia Falkland Islands Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibralter Granada Greece Greenland Guadeloupe Guatemala Guinea Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Mali Malta Martinique Mauritius Mexico Moldova Monace Mongolia Montenegro Morocco Mozambique Nepal Netherlands New Caledonia New Guinea New Zealand Nicaragua Niger Nigeria North Ireland Oman Pakistan Panama Paraguay Peoples Republic of China Peoples Republic of Congo Peru Philippines Poland Portugal Qatar Republic of Macedonia Republic of South Africa Republic of Zaire Romania Russia Rwanda Saint Vincent Santa Lucia Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Somali Republic Southwest Africa Spain Sri Lanka Sudan Surinam Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad Tunisia Turkey Turkmenistan UAE Uganda Ukraine Upper Volta Uruguay USA Uzbekistan Vatican City Venezuela VietnamVirgin Islands Wales Western Samoa Yemen Zambia Zimbabwe
Date of Birth January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950
Are you employed? Yes No If yes, Employer
Employer’s Address
Employer’s Phone Number Email Address
Contact at Kansas State University
Telephone Number Email
Proposed Major Expected Date of Graduation
I affirm the information that I have (will) provided on this application form, or any supporting materials, is (will be) complete, accurate, and true to the best of my knowledge. I understand that furnishing false information may result in not being considered or revocation of the scholarship at some later date. I understand that, if selected for a scholarship, you may use my photograph and/or testimonial for promotion and public relations purposes.
Signature of Applicant Date
In addition to this application, please send the supporting materials listed below to:
International Milling Education Foundation
Scholarship Committee
10100 W. 87th Street, Suite 306
Overland Park, KS 66212-4628
1. Two letters of reference.
2. Personal Statement, which should include
· Demonstrated timeliness and completion of assignments
· Creativity in solving problems
· Demonstrated responsibility on own initiative
· Ability to work well with others
· Organization skills (ability to handle multiple tasks, time management)
· Participation in class, campus and outside organizations
· General background information
· Career objective
· Description of any milling related work experience
3. Transcript including course information in grain or milling science (if applicable)
4. Verification of enrollment (for fall 2009 semester)
IMEF Spotlight
Research Products Company Makes Donation to IMEF
Bay State Makes IMEF Donation in Memory of Bernard J. Rothwell II
James, Steve and Susan Doyle donate $16,000 to IMEF in memory of Mike Doyle
Bill and Brenda Dutton honor William and Doloris Dutton, and John Gibson, with personal contribution to IMEF
Richard Ferrell honors his mentor, Richard "Dick" Bradford