Asotin LionsClub
2015HighSchoolGraduateScholarshipApplication
Eligibility:Any2014highschoolgraduatingseniorwhoresidesinthe
AsotinSchoolDistrictiseligible toapply.
Scoring:
CommunityService- Academics Essay/Honors-
TotalPossible-
500Points
400points
100points
1000points
ApplicationProcess:Thisapplicationmust befiledwiththeAsotin
LionsClub,Scholarship Committee,POBox175,Asotin,Washington
99402,nolaterthanMay9,2015.Applicantsand/orfinalistswillbe invitedtoattendandpresent atanAsotinLionsClubmeeting.Awards willbeannounced atthegraduationceremony.
1. Applicantshouldhaveabackgroundinvolunteerandcommunity
2.Applicantshouldhavea2.5overall gradepoint ascertifiedby schooltranscript.
3.Applicantmust provide a250minimumto500wordmaximum essayastowhythefundsareneeded,howthescholarshipwould changeyourlife,howitwouldallowyoutofurtheryoureducation and yourservicetothecommunity.
4.Student must beacceptedatauniversity,college,vocationalor technicalinstitutionandattendfull-timeaminimumofoneacademic year.
5.Applicant must submitallrequired applicationinformation.
6.Finalistsmust giveabrief,5to10minutepresentationatanAsotin
LionsClubmeeting (May 27,2015).
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HonorsandAwards
Includescholastic,extracurricular,communityandclub/organization honorsandawardsreceivedgrades9through12.Statenatureof award andawardingorganization.Youmayinclude abrief,upto25 word,descriptionandpurpose ofeachawardonaseparate attached page.
(Continueonseparate sheetifneeded)
ActivitiesandOrganizationsyouparticipatedinforoneormore years
Includeallcommunity,scholastic,extracurricularandcivic organizationsthat youparticipatedinduring grades9through12,and include positions ofleadership.Statenameoforganizationand leadership position ifany,andgradesinvolved,startingwithmost recent:i.e.LoyalOrderofRaccoons,9,10,11,GrandPoobah,12;Ping Pong10,11,Captain12.
(Continueonseparate sheetifneeded)
ApplicantEssay
Pleaseprepare andattach anessayof250wordsto500wordsstating therolecommunityservicehasplayedinyourhighschool accomplishments,yourcareeraspirations,andinachievingyourlife goals.Alsoinclude whythefundsareneeded,howthescholarship wouldchangeyour life,howitwouldallowyoutofurtheryour education andyourservice tothecommunity.
CommunityService
Listallvolunteerwork orcommunityservice youperformedwithout pay.Pleaselisttotal hoursworked,notaverage hoursper week/month.Youmayexplain further inyournarrative/essay.
TotalHours/Datesofwork/serviceKindofwork/serviceNameof organization
Ex:8hrs12/24/06 InventoryingfoodFoodBank
(Continueonseparate sheetifneeded)
Employment
Listjobsyouhaveheld.Includedomestic,baby-sittingandworkfora family farmorbusiness,evenifnotpaid.Pleaselisttotalhours worked,notaverage hoursperweek/month.
TotalHoursDatesofwork/serviceKindofwork/serviceNameof organization
(Continueonseparatesheetifneeded)
Name__
StreetAddress
City,StatePhone_ DOB _
Bysigning thisapplication,youagree,ifasked,toprovide information that willverify theaccuracy ofyourcompletedform.Youalsoagree AsotinLionsClubofficials maycontact employers,organizationsand referenceslisted onthisapplication.
Signedby:------=D=a=te:
Signedby:
Dat=e
(Mother/Father/Guardian]
YourHigherEducationPlans
Stateyourplansforenrollmentinanaccredited education institution includingyourplanned major.
Asotin LionsClub
2015HighSchoolGraduateScholarshipApplication
SchoolReport
Applicant:Complete theStudentNamesectiononlyonthispageand giveittoyourcounselor.
StudentName:
Counselor:Pleaseprovide thefollowing informationtohelpusrate theapplicants.
1.Thestudent'sgradepoint average (A= 4.0) _
2. Thehighest GPAinthegraduatingclass _
3.Thisstudentranksinaclassof
4.Howwouldyoudescribethisstudent'sacademic program?
_BelowAverage,_AverageCoursework,_CollegePrep
Courses
5.Isthisstudent'sacademic programappropriatefortheirability level?
_Belowlevel,_Atlevel,_Abovelevel,_Exceedslevel
6.Pleaselistanyscholarshipsortuitionwavers thisstudent is receiving.
7.Irecommendthisstudent foraAsotinlionsScholarship asfollows: Forcommunityservice (low) 123456(high)
Foracademicability (low) 123456(high)
8.Ifurtherrecommendthisstudent forthefollowing reasons:
Name------Lengthoftime acquaintedwithstudent _
SchoolPosition------
ContactPhone/email
SignatureDate
PleasesecurethisschoolreportformInasealedenvelope andgiveit tothestudent toinclude withhisorherapplication.Thankyoufor yourassistance.
AsotinLionsClub
2015HighSchoolGraduateScholarshipApplication
ConfidentialReport
-Reference-
Thestudent listed belowisapplyingforscholarships tobeawarded to a2014highschoolgraduate.Allinformationthat youprovide willbe keptconfidential.Pleasereturnthisformtothestudent ina confidentialenvelope assoonaspossible.
Allapplicationsare duenolaterthanMay9,2015.
Applicant:Complete theStudentNamesectiononlyonthispageand giveittoyourreference.
StudentName:
Thefollowinginformationistobecompleted byareference and returneddirectlytotheapplicant,sealedinaconfidentialenvelope. Thankyouforyourassistance.
Whatisyourassociation withtheapplicant? (teacher,employer,pastor,neighbor,etc.)
Howlonghaveyouknown theapplicant? _
I recommendthisstudent foraAsotinLionsScholarship asfollows: Forcommunityservice (low) 123456(high)
Whatisyourestimateoftheapplicant'sability andmotivationto succeedinhigher education.
(below average)123456(superior)
I furtherrecommendthisstudentforthefollowingreasons:
(Continueonreverse ifneeded)
PrintedNameandntle
Address
ContactPhone/email
Signature._Date _
ConfidentialLettersofRecommendationandSchoolReport
Pleaseinclude oneletterofrecommendationfromamemberofthe community(ie.anemployer)andonefromahighschoolteacher. Letters must besignedandsubmittedinasealedenvelope bythe reference.TheSchoolReportmustbecompletedbyyourguidance counselor orappropriateschoolofficialandsecuredandsealedinan envelope andincludedwithyourapplication.
ApplicationCheckListYourapplicationmust include thefollowing:
_3-page Application form
_CopyofOfficialtranscript
_250-500wordEssay
_SealedSchoolReport
2-SealedReferenceLetters