John Deere Dealer Scholarship Sign-Up
*Please note that the enrollment period has passed and this form is no longer active.*

Total Number of Scholarships *
Dealer or Customer Code*
Dealership Name*
Mailing address 1*
Mailing address 2
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) 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

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. *