WROF Scholarship Award Recipient Information | Wisconsin Rural Opportunities Foundation, Inc.

(If you are a high school senior applying for a scholarship from the WROF, Inc. Premier Award Program, please visit here to complete and submit a scholarship application.)

WROF Scholarship Recipient Information Form

Date
MM slash DD slash YYYY

Congratulations on receiving a scholarship or support from the Wisconsin Rural Opportunities Foundation, Inc.! Our mission is to foster vitality in rural Wisconsin by investing in you! Thank you for creating bright futures for generations to come in rural Wisconsin. If you have any questions about this form, please contact Marcy Heim, Executive Director at marcy@marcyheim.com.
First Name*

Enter your first name.
Middle initial

Enter your middle initial.
Last Name*

Enter your last name.
Current Street Address*

Enter your current street address.
Current City*

Enter the city where you currently live.
Current State*

Enter the state where you currently live.
Current Zip Code*

Enter the zip code where you currently live.
Parent(s)/Guardian(s)'s First Name
Parent(s)/Guardian(s)'s Last Name
Permanent (Hometown) Street Address*

If different from your current address, enter your permanent street address. If it is the same as your current address, enter "same."
Permanent (Hometown) City*

Enter the city where your permanent address is. If it is the same as your current city, enter "same."
Permanent (Hometown) State*

Enter the state where your permanent address is. If is the same as your current address, enter "same."
Permanent (Hometown) Zip Code*

Enter the zip code where your permanent address is. If it is the same as your current address, enter "same."
Home Phone*
Cell Phone*
Email*
All 3 boxes must be checked in order to receive a scholarship award from WROF, Inc.*
- As a recipient, I agree to receive WROF's e-news and other periodic mailings.
- At this time, I plan to return to rural Wisconsin upon graduation.
- I give my institution permission to periodically provide WROF, Inc. my updated contact information.
College/University*

Enter the college/university you are attending (i.e. UW-Stevens Point, Edgewood College)
Program/College*

Enter the college or program where you are pursuing your degree (i.e. College of Nursing, Farm & Industry Short Courses, and School of Veterinary Medicine)
Major field of study*
Name of Hometown Newspaper*
High School(s)*

Enter high school(s) attended and the city, state where located
Year of HIgh School Graduation*
Organization memberships and leadership positions held:
Discuss what your plans are when you return to rural WI after graduation
I give permission to use my comments in future publications or other media.*
- Yes
- No
Thank you, and congratulations, again!

WROF Scholarship Recipient Information Form

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Fostering the Vitality of Rural Wisconsin since 1934