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WIA SCHOLARSHIP APPLICATION FORM

Please complete the form below to apply for the Women in Agribusiness scholarship to attend the Women in Agribusiness (WIA) Summit in Dallas, Texas on September 26-28, 2022. Click here for more information on scholarship benefits, requirements and eligibility.

Attendee information

Email address(Required)

Confirm email address(Required)

Send copies of event emails to (separate emails with commas)

Headshot (to be used in event application)(Required)

Max. file size: 200 MB.

Name(Required)

First Last

Nickname

Contact Information

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mobile phone(Required)

Twitter Handle

LinkedIn URL

Facebook ID

Instagram Handle

Application details

Have you previously applied for a WIA scholarship?(Required)

Yes

What year did you apply?

Please enter a number from 1990 to 2022.

College / University you attend(Required)

Current college degree level(Required)

Undergraduate

Graduate

PhD

Other

Department or major(Required)

Degree expected(Required)

Colleges / Universities previously attended (provide college name, date and degree)

Resume (File formats: .pdf, .docx)(Required)

Accepted file types: pdf, docx, Max. file size: 200 MB.

Files in the .doc format are not able to be accepted via this form. Please save as a .docx or .pdf.

Please share why you are passionate about agriculture, how you see yourself contributing to the industry, and what you would gain from attending the summit. (Approx. 500-700 words. File format: .pdf, .docx)(Required)

Accepted file types: pdf, docx, Max. file size: 200 MB.

Files in the .doc format are not able to be accepted via this form. Please save as a .docx or .pdf.

Sum up your career goal in one sentence.(Required)

Other registration details

Pursuant to the Americans with Disabilities Act, do you require specific aids or services?

How did you hear about this scholarship (Enter agency, ProAg employee or policyholder name)?

Is this your first time attending a WIA event?

Yes

Acknowledgment of terms

I affirm that the information provided in my application is to the best of my knowledge, complete and accurate, and I understand that false statements on this application will disqualify me from consideration for the scholarship.

I acknowledge that if chosen for a scholarship:

My goals and headshot will be featured on the WIA website, on social media, and on the WIA Summit App.
I will attend the summit and participate in all required sessions.
I may be asked to aid with summit set-up and activities.
I will make myself available to meet with ProAg at the summit event.
I will make myself available to ProAg to interview me after the summit to create a press release, and feature my story and image on their digital platforms / publications.
I will notify my professors and/or counselors, in a timely manner, of my plans and absence per college/university policies.
I am voluntarily participating in this summit event. I understand that there are risks associated with my participation such as injury, illness, disability, death or economic loss. These injuries or outcomes may arise from my own or other’s actions, inactions or negligence. Nonetheless, I assume all risks of my participation in this event, whether known or unknown to me, including travel to and from the event or any events incidental to this event.
I agree to hold ProAg harmless from any and all claims, loss or damage to my personal property, liabilities and costs, including attorney’s fees, as a result of my participation in this Summit event, including travel to and from the event or any events incidental to this event. If ProAg incurs any of these types of expenses due to my actions, I agree to reimburse ProAg.

Name

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