American FFA Degree Application - Worksheet Sponsored as a special project of the National FFA Foundation by: Applicant Information Applicant Name Chapter Name Statement of Candidate and Parent/Guardian We have prepared this application and certify that the records are true, complete and accurate and we hereby permit for publicity purposes the use of any information included in the application with the exception of the following: Date Parent/Guardian Signature Date Candidate's Signature Certification We have verified the application and find that the statements contained herein are such that we are able to recommend him/her for the American FFA Degree. Furthermore, we verify that he/she has conducted themselves in a manner to be a credit to the organization, chapter, school and community. Date Chapter President Signature Date Chapter Advisor Signature Date Superintendent or Principal Signature Date State Advisor or State Executive Committee Signature Candidate's Scholastic Record I hereby certify this applicant has achieved a high school record of "C" or better and has a satisfactory record of scholarship and participation in school activites. Date Administrator or Counselor (indicate which)
American FFA Degree Application Sponsored as a special project of the National FFA Foundation by: Applicant Contact Information Name as you want it to appear on the certificate Name on the FFA Chapter Roster (if different) Gender DOB Name Pronunciation Address City State Zip Code Email Address Home Phone Father/Guardian Name Mother/Guardian Name Parent/Guardian Email Address Parent/Guardian Phone Chapter Information FFA Chapter Name School Name School Address School City School State School Zip Code School Phone Chapter Advisor(s) Page 2 of 14
American FFA Degree Application Sponsored as a special project of the National FFA Foundation by: FFA History Year FFA Membership Began Year Received State FFA Degree Had continuous active FFA membership for the past 24 months? Have your State and National FFA Dues been paid? Education Information High School Graduation Year If not, give date left school Years of Ag Education Offered (grades 7-12) in high school last attended Ag Education completed in High School Postsecondary/Vo-Tech Education Completed Four-year College Completed Years: : Semesters: Quarters: Semesters: Quarters: Major School Attended Military Duty - Dates of Full-Time Active Military Duty World Experiences in Agriculture - Date of International Placement Have you complied with all regulations for filing local, state and federal tax returns? If Yes, what years did you file the required returns? Page 3 of 14
Basic Award Setup Information I. Application Dates Date Started Ag (mo/day/year) / / Application Ending Date December 31, II. SAE Types - (Select all that apply) Exploratory, Supplemental, or Improvement Research Placement Entrepreneurship III. Assets 1. /Operating Assets a. Cash on hand, checking and savings b. Cash value - bonds, stocks, life insurance c. Notes & Accounts Receivable d. Inventory (Entrepreneurship Experiences) 1. Investment in harvesting and growing crops 2. Investment in feed, seed, fertilizer, chemical, supplies, prepaid expenses, and other current assets 3. Investment in merchandise, crops and animals purchased for resale 4. Investment in raised market livestock & poultry 2. Non- Inventory a. Investment in non-depreciable draft, pleasure, and breeding animals b. Investment in depreciable draft, pleasure, and breeding animals c. Investment in depreciable machinery, equipment, and fixtures d. Investment in depreciable land improvements, buildings, and fixtures e. Investment in land Beginning Value Beginning Value Ending Value Itemized ending inventory values are reported on "Ending Inventory" page. Ending Value Itemized ending inventory values are reported on "Ending Non- Inventory" page. IV. Liabilites a. Accounts and notes payable b. portion of non-current debt (the portion of non-current debt during this calendar year) c. Real Estate Mortgages (total real estate mortgages minus current portions) d. Other non-current liabilities (total other non-current liabilities minus current portions) Beginning Value Ending Value V. Personal Cash Income & Expense a. Sources of cash gifts b. Sources of Assets from Ag-Related but Non-SAE c. (Deduct) Personal Draw d. (Deduct) Education Taken Out Value Page 4 of 14
Supervised Agricultural Experience - Research Research Title Year 1 2 3 4 5 PROJECTS: 5 Page 5 of 14
Supervised Agricultural Experience - Placement and Exploratory Page 6 of 14
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Supervised Agricultural Experience - Entrepreneurship Page 8 of 14
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Candidate Inventory Statement - Inventory A. Harvested and Growing Crops/Plants Description Quantity Value B. Feed, Seed, Fertilizer, Chemicals, Supplies, Prepaid, and other Assets Description Quantity Value C. Merchandise, Crops, and Animals Purchased for Resale Description Quantity Value D. Raised Market Animals Description Quantity Value Page 10 of 14
Candidate Inventory Statement - Non- Inventory E. Non-Depreciable Draft, Pleasure, or Breeding Animals Description Quantity Value F. Depreciable Draft, Pleasure, or Breeding Animals Description Acquisition Cost Depreciation Claimed Value G. Depreciable Machinery, Equipment, and Fixtures Description Acquisition Cost Depreciation Claimed Value H. Depreciable Land Improvements, Buildings, and Fences Description Acquisition Cost Depreciation Claimed Value I. Land Description Quantity Acquisition Cost Page 11 of 14
Income and Expense Summary of Entrepreneurship SAE Program 1. Revenues from Operations a. Closing Inventory b. Beginning Inventory c. Change in Inventory d. Cash Sales e. Value Used at Home (Non-cash) f. Value of Production Transferred to other enterprise, Transferred to Non-, Bartered or Labor Exchanged or gifts (Noncash) h. Revenues (Change in Inventory and Sales) 2. from Operations a. Inventory Purchased for Resale (Cash) b. Inventory Purchased for Resale (Non-Cash Transfers) c. Cash (all other types) d. Non-Cash (Transferred, Bartered, or SAE Labor Exchange) e. Contributed Non-Cash (Gift or non- SAE Labor Exchange) f. Operating Yr: Yr: Yr: Yr: Yr: Yr: 3. Net Income from Operations 4. Non- Inventory a. Closing Inventory b. Transfer in from Operations (Non-Cash Transfers of non-current assets) c. Contributed Inventory (Outside contribution of non-current assets - gift) d. Purchases e. Beginning Inventory f. Sales e. Net Non- Transactions 5. Net Income From Operations & Net Non- Transactions 6. Annual Profitibility Measures a. Operating Profit Margin (OPM) Net Operating Income/s Sales = % of sales related to profit b. % of Returns from Net Non- Gains (Net Non- Gains/ Gains) c. Review of Non- Ending Inventory Value 7. Non-Cash Transfer/Exchange Review a. Check if Non-Cash Transactions are Balanced b. If "No", what is the difference that non-cash income categories minus Non-Cash and Non- are off? Page 12 of 14
Yr: Yr: 1. Revenues from Operations a. Closing Inventory b. Beginning Inventory c. Change in Inventory d. Cash Sales e. Value Used at Home (Non-cash) f. Value of Production Transferred to other enterprise, Transferred to Non-, Bartered or Labor Exchanged or gifts (Noncash) h. Revenues (Change in Inventory and Sales) 2. from Operations a. Inventory Purchased for Resale (Cash) b. Inventory Purchased for Resale (Non-Cash Transfers) c. Cash (all other types) d. Non-Cash (Transferred, Bartered, or SAE Labor Exchange) e. Contributed Non-Cash (Gift or non- SAE Labor Exchange) f. Operating 3. Net Income from Operations 4. Non- Inventory a. Closing Inventory b. Transfer in from Operations (Non-Cash Transfers of non-current assets) c. Contributed Inventory (Outside contribution of non-current assets - gift) d. Purchases e. Beginning Inventory f. Sales e. Net Non- Transactions 5. Net Income From Operations & Net Non- Transactions 6. Annual Profitibility Measures a. Operating Profit Margin (OPM) Net Operating Income/s Sales = % of sales related to profit b. % of Returns from Net Non- Gains (Net Non- Gains/ Gains) c. Review of Non- Ending Inventory Value 7. Non-Cash Transfer/Exchange Review a. Non-Cash Transactions Bal. (1f = 2b+2d+4b) b. If "Not Bal.", what is the value off? Non-cash entry lines should equal. If not review. Page 13 of 14
Community Service Year: Group/Organization Activity Name Year: Group/Organization Activity Name Year: Group/Organization Activity Name Year: Group/Organization Activity Name Year: Group/Organization Activity Name Year: Group/Organization Activity Name Page 14 of 14