Youth Scholarship Application - Chippewa Valley Beekeepers Association

Applicant Name *

First

Last

Date of Birth

Name of School Attending and current grade

Phone

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent / Guardian Name *

First

Last

Will you need a place to keep you bees?

Yes, I will need a plot at the Xcel Apiary
No, I have a location already in mind

If No, where will the apiary be located?

Any extracurricular activities that we would need to take into consideration when scheduling mentorship times?

Any group affiliations (BSA, Girls Scouts, 4-H etc.) These are not essential, but could help with selection.

Do you know or have a relationship with an current member of the Chippewa Valley Beekeepers Association? If so, whom, and what is your relation to the club member?”

What is your current experience level with beekeeping / do you have any prior knowledge with honeybees?

Why do you want to keep bees / what do you hope to gain form this experience?

Waiver *

I AND my Parent / Guardian agree to the Waiver/Binder statements