AGCO Dealer Scholarship Sign-Up

 
Total Number of Scholarships *
 
 
Total Number of Grants*
 
 
Dealer or Customer Code*
 
 
 
Dealership Name*
 
 
Mailing address 1*
 
 
Mailing address 2
 
 
City*
 
 
State*
 
 
Zip Code*
 
 
Primary Contact: First Name*
 
 
Primary Contact: Last Name*
 
 
Business Email*
 
 
 

FFA scholarship recipients send thank you notes to the dealerships that sponsor them. If the thank you should be sent to a contact that is different from the primary contact, enter the thank you contact information below. If the thank you should be sent to the primary contact, skip the section below.

 
Thank You Contact: First Name
 
 
Thank You Contact: Last Name
 
 
Thank You Contact: Email Address
 
 
Thank You Contact: Street Address
 
 
Thank You Contact: City
 
 
Thank You Contact: State
 
 
Thank You Contact: Zip Code
 
 
 
 

 
FFA Chapter Information

The dealership would like to award sholarship(s) and/or grant(s) to the following FFA chapter(s).*
To find a local FFA chapter, search here.

 
Chapter 1 Name*
 
 
Chapter 1 City*
 
 
Chapter 1 State*
 
 
Chapter 2 Name
 
 
Chapter 2 City
 
 
Chapter 2 State
 
 
Chapter 3 Name
 
 
Chapter 3 City
 
 
Chapter 3 State
 
 
Number of Scholarships for Chapter 1*
 
 
Number of Scholarships for Chapter 2
 
 
Number of Scholarships for Chapter 3
 
 
Number of Grants for Chapter 1
 
 
Number of Grants for Chapter 2
 
 
Number of Grants for Chapter 3
 
 

 
Payment Options (choose one)*
 
Pay Now (in confirmation email)
Send Invoice
 
 

In the event that there are not enough eligible applicants using your original criteria, National FFA offers the following awarding options:

 
Ineligibility Criteria Options (choose one)*
 
 
I understand that by submitting this form, I agree to this contribution. *