USDA 1994 Tribal Scholars Program College Student Application

OMB No.:0503-0016

USDA 1994 TRIBAL

SCHOLARS PROGRAM

APPLICATION

For students seeking careers in Food, Agriculture,

and Natural Resource Sciences, and/or other

Related Disciplines.

Due February 15, 2022

OMB No.:0503-0016

INTRODUCTION

Thank you for your interest in the U.S. Department of Agriculture (USDA) 1994 Tribal

Scholars Program. The USDA 1994 Tribal Scholars Program was established to

strengthen the long-term partnership between USDA and the 1994 Land-Grant

Institutions by increasing the number of students studying, graduating, and pursuing

careers in in food, agriculture, natural resources, and other related fields of study.

The USDA 1994 National Scholars Program is implemented under the USDA Fellows

Experience Program (FEP). Successful applicants will receive a temporary

appointment to the USDA, not to exceed 4years. Upon successful completion of the

degree requirements and the end of the agreement period, the scholar is eligible for

conversion to permanent appointment in service to USDA without further competition.

The USDA 1994 National Scholar is required to:

 Be a U.S citizen

 Have been admitted as well as enrolled as full-time student in a 1994 Land-Grant

Tribal

College or University or be a recent graduate of one of these schools.

 Maintain a GPA of 3.0 or better on a 4.0 scale.

 Have demonstrated leadership and community service.

 Have submitted an official transcript with a school seal and/or the signature ofan

authorized school official.

 Submit an essay that is 500-800 words describing 1) What motivates you to

consider a career in public service working for the U.S. Department of Agriculture.

Include information about your educational and career goals and how this

scholarship may assist you to achieve them; 2) How did you become interested in

studying food, agriculture, and natural resource sciences or another related

discipline in college.

OMB No.:0503-0016

1994 Tribal Land-Grant Colleges and Universities are:

Aaniiih Nakoda College - MT

Bay Mills Community College - MI

Blackfeet Community College - MT

Cankdeska Cikana Community College - ND

Chief Dull Knife College – MT

College of Menominee Nation - WI

College of Muscogee Nation – OK

Diné College - AZ

Fond du Lac Tribal and Community College - MN

Fort Peck Community College - MT

Haskell Indian Nations University - KS

Ilisagvik College - AK

Institute of American Indian Arts – NM

Keweenaw Bay Ojibwa Community College- MI

Lac Courte Oreilles Ojibwa Community College - WI

Leech Lake Tribal College – MN

Little Big Horn College - MT

Little Priest Tribal College - NE

Navajo Technical University – NM

Nebraska Indian Community College - NE

Northwest Indian College - WA

Nueta Hidatsa Sahnish College - ND

Oglala Lakota College - SD

Red Lake Nation College - MN

Saginaw Chippewa Tribal College - MI

Salish Kootenai College - MT

Sinte Gleska University - SD

Sisseton Wahpeton College - SD

Sitting Bull College - ND

Southwestern Indian Polytechnic Institute -NM

Stone Child College - MT

Tohono O’odham Community College - AZ

Turtle Mountain Community College - ND

United Tribes Technical College - ND

White Earth Tribal and Community College – MN

OMB No.:0503-0016

THIS IS A FILLABLE FORM. IF POSSIBLE, PLEASE COMPLETE FORM ON

COMPUTER.

Affirmation of Candidacy and Authorization for Release Information:

I, , understand that I am a candidate for the honor of

USDA 1994 Tribal Scholar, have read the Privacy Act Advisory Statement, and affirm that I wish

to be considered. In the event I am named a USDA 1994 Tribal Scholar, permission is hereby

given for the release of materials submitted by me for the use of the U.S. Department of

Agriculture and the 1994 Land-Grant Institutions as deemed appropriate for purposes of the

USDA 1994 Tribal Scholars Program. I further consent to the release of photographs which may

be taken of me, by or for the U.S. Department of Agriculture, in connection with the Program.

Signature: Date:

I am willing unwilling to appear on radio and/or television if such arrangements can be

made by the U.S. Department of Agriculture in connection with the USDA 1994 Tribal

Scholars Program.

I am a current high school student:

I am a current college student:

I am a returning college student:

OMB No.:0503-0016

SECTION I: PERSONAL

Prefix: Mr. Mrs. Ms. Miss

Last Name: First Name: M.I.:

Suffix: Preferred Name:

Sex: Male Female Unknown

U.S. Citizen: Yes No

Telephone: Email Address:

SECTION II: MAILING ADDRESS

Permanent Address:

City: State: Zip Code:

SECTION III: EDUCATION

Name of College:

Location (City/State):

GPA (4.0 Scale):

Currently Enrolled in College? Yes

No If YES, Fill out information below

Anticipated or Declared Major(s):

inor(s):

Advisor’s Name/Contact (if available):

OMB No.:0503-0016

SECTION IV: OTHER EDUCATION

List from most to least recent any other college(s) attended in the last 4 years

Name of School

Location (City &

State)

Dates of

Attendance

SECTION V: ORGANIZATIONS/PROGRAMS

List from the most to least recent any advanced or special programs, or summer

courses you have taken.

Course/Program

Name of

School

Location (City&

State)

Dates of

Attendance

Hours/

Week

SECTION VI: TRANSCRIPTS

If you have not received any college credit, you must provide an official signed and sealed transcript from

your high school and include it with your application. If you have received any college credit, you must

provide an official signed and sealed transcript from every college or university you have attended and

include them with your application. The USDA 1994 Program will accept an unofficial transcript from the

college registrar provided it meets the deadline and a receipt from the registrar is included indicating an

official, signed transcript is being sent.

OMB No.:0503-0016

SECTION VII: COURSE OF STUDY

The USDA 1994 Tribal Scholars Program offers a year-to-year scholarship for eligible students.

Place an X in the boxes below for all that apply. I am applying for:

2-Year Scholarship Support

3 Year Scholarship Support

4 Year Scholarship Support

Are you enrolled in an Associate’s Degree (2-Year) Program?

Yes. If yes, please indicate field of study:

2. Are you enrolled in or planning to enroll in a Bachelor’s Degree Program?

Yes. If yes, please indicate field of study:

No.

3. Are you currently planning to enroll in an Associate’s Degree (2-Year) Program and plan

with the intention of transferring to a Bachelor’s Degree Program elsewhere (“2 + 2

Program”)?

Yes

SECTION VIII: EXTRACURRICULAR AND EMPLOYMENT ACTIVITIES

List any activities in which you have participated in or outside school, i.e. sports, music,

student government, clubs, church, civic, etc.

Activity

Dates of Participation

Offices Held

Special Awards,

honors, recognition

OMB No.:0503-0016

List all volunteer services or jobs held in the last 3 years.

Volunteer

services/Jobs

Name of Employer

/organization

Dates of service

/employment

Hours

/Week

Special

Awards

OMB No.:0503-0016

SECTION IX: ESSAY QUESTION

Essay must be addressed to the USDA 1994 Selection Committee

Write a 500-800 word essay describing: 1) What motivates you to consider a career in public

service working for the U.S. Department of Agriculture. Include information about your

educational and career goals and how this scholarship may assist you to achieve them; 2) How

did you became interested in studying food, agriculture, and natural resource sciences or

another related discipline in college; and 3) How USDA will benefit if you are selected for the

USDA Tribal Scholars Program (immediately and in the long term).

SECTION X: RECOMMENDATION INSTRUCTIONS

You will need to submit two letters of recommendation from two different sources addressing the

following question: “Considering what you know of the applicant’s interests, work habits,

and life goals, what is your assessment of the chances that the applicant will be

motivated to take advantage of the opportunities available in college and with the

USDA?” One recommendation must be from someone who knows your academic work. The

second recommendation can be from (as an example) a current or previous school counselor,

teacher, principal, tribal college and university president, or employer. Make sure the

recommendation is from someone who knows you well and can comment on your abilities.

WHERE TO SEND RECOMMENDATION AND APPLICATIONS

Recommendations will need to be sent to following email address: [email protected] or via

regular mail to:

Office of Partnerships and Public Engagement

USDA 1994 Tribal Scholarship Program

U.S. Department of Agriculture

1400 Independence Avenue, SW.

Stop 0601

Washington, D.C. 20250

Tel:(202) 720-6350

SECTION XI: CHECK LIST

I have read this section, especially those elements detailing the eligibility requirements,

schools that I must attend, and the February 15, 2022 deadline in which my completed

application package must be postmarked.

I have included an official signed and sealed transcript or have included an unofficial

copy of my transcript from the college registrar and a receipt from the same registrar to

indicate the official copy will be received shortly from the schools I have attended and

have included any and all in my application package.

I have written my essay and included it in my application.

I have given Letter of Recommendation instructions to my counselor or teacher or other

recommender to fill out and will have these sent to the following address:

One of these recommendations will come from someone who knows my academic

work.

OMB No.:0503-0016

I have applied to all the schools I want to attend.

I will send all application materials to either this email [email protected] or to

Office of Partnerships and Public Engagement

USDA 1994 Tribal Scholarship Program

United States Department of Agriculture

1400 Independence Avenue, SW.

Washington, DC 20250

Tel: (202) 720-6350

SECTION XII: SIGNATURES

Please review this form to make sure you have answered all the questions completely.

I certify that I have completed this application and that all statements are true and

accurate to the best of my knowledge. Any false statements may eliminate me from

consideration for this scholarship.

Signature of Applicant

Date

Signature of Parent or Legal Guardian (if applicant is under 18 years of age)

Date

OMB No.:0503-0016

AUTHORITIES

The USDA 1994 Tribal Scholars Program is implemented under the USDA Fellows

Experience Program (FEP). Tribal Scholars accepted into the program will be accepted

under Schedule A in 5 CFR § 213.3102 (r) for temporary appointments not to exceed 4

years based on defined criteria. Upon graduation, Tribal Scholars will be eligible for

noncompetitive conversion to full time employment.

• 5 Code of Federal Regulations Part 213—Excepted Service, Student Educational

Employment Program—Student Career Experience Program

• 5 Code of Federal Regulations Part 410—Training

• Equity in Education Land Grant Status of 1994

• Executive Order 12015, Permitting students completing approved career-related

work-study programs to be appointed to career or career conditional positions in

the competitive service

• Executive Order 13562, Recruiting and Hiring Students and Recent Graduates

• Executive Order 13270, Tribal Colleges and Universities (2002)

• Executive Order 13592, Improving American Indian and Alaska Native

Educational Opportunities and Strengthening Tribal Colleges and Universities

• Food, Agriculture, Conservation and Trade Act of 1990; P.L. 101-624, Sec. 2501,

Sec. 2830

• Federal Agriculture Improvement and Reform Act of 1996

• Conversion to Career Conditional Appointment Farm Bill 2018 (5 CFR 213.3102)

authority code “ZLM”.

According to the Paperwork Reduction Act of 1995, an agency may not conduct or

sponsor, and a person is not required to respond to a collection of information unless it

displays the valid OMB control number, 0503-0016. The time required to complete this

information collection is estimated to average 4.0 hours per response, including the time

needed for reviewing instructions, searching existing data sources, gathering and

maintaining the data needed and completing and reviewing the collection of information.

Privacy Act Advisory Statement

The Privacy Act of 1974 (P.L. 93-579) requires that you be given certain information in

connection with this request for information.

Accordingly, pursuant to the requirements of the Act, please be advised:

• The authority of the collection of these data is Executive Order 11155.

• Furnishing the information requested is voluntary.

• The data will be used for selection of USDA 1994 Tribal Scholars, printing of

certificates, and related activities.

• Other routine uses of the data are for preparation of the public affairs and press

releases to news media.

OMB No.:0503-0016

United States Department of Agriculture

USDA 1994 Tribal Scholars Program

Office of Partnerships and Public Engagement

1400 Independence Avenue, SW.

Washington, D.C. 20250

Tel: (202) 720-6350

Email: 1994@usda.gov

"The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and

activities on the basis of race, color, national origin, age, disability, and where applicable, sex,

marital status, familial status, parental status, religion, sexual orientation, genetic information,

political beliefs, reprisal, or because all or a part of an individual's income is derived from any

public assistance program. (Not all prohibited bases apply to all programs.) Persons with

disabilities who require alternative means for communication of program information (Braille,

large print, audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice

and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights,

1400 Independence Avenue, S.W., Washington, D.C. 20250-9410 or call (800) 795-3272

(voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer."

USDA is an equal opportunity employer.