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1. Student Information

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2. Adviser's Information

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3. What grade levels have you been an affiliated FCCLA member?

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4. List ways you have participate in FCCLA?

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5. List any offices held on the chapter or district level

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6. In what ways do you believe attending the State Leadership Conference will benefit you?

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7. Why do you financially need this scholarship?

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8. Advisers please include a short paragraph indicating the students leadership qualities, financial need, and impact of the award.

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