ROTARY CLUB OF GRANDE PRAIRIE

Meets: Friday 12:15 at Quality Inn

ROTARY SERVICE SCHOLARSHIPS

APPLICATION FORM

Limited to grade 12 students in the current school year atGrande Prairie Composite High School.

There are 5 scholarships available forGrande Prairie Composite High School students attending post secondary education, each valued at $1000.00.

  1. Attending as a full time student at: GPRC- one award.
  2. Attending a post secondary institution: Anywhere- two awards.
  3. Attending as a full time student: Technical School- one award.
  4. Attending as a full time student: Fine Arts- one award.

Indicate the one(s) for which you are applying for:

  1. First Choice______
  1. Second Choice______

SECTION ONE – Personal Data:

Applicant’s name: ______

Permanent Home Address: ______

City Province Postal Code

Date of Birth: ______Phone#: ______

Current Mailing Address: ______

______

City Province Postal Code

SECTION TWO – Proposed Studies:

Post Secondary Institution that

Application refers to: ______

Location: ______

Faculty or College: ______

Program or major subject: ______

Period of full-time attendance: From: ______To: ______

Month/Year Month/Year

PROVIDE DOCUMENTATION OF CONFIRMATION OF REGISTRATION/ACCEPTANCE

THE ROTARY CLUB OF GRANDE PRAIRIE

ROTARY DISTRICT 5370

CHARTERED 1951

SECTION THREE – References:

The Selection Committee requires two letters of reference. These letters should be sealed and attached to your application:

  • One from a teacher.
  • One from a supervisor (either a volunteer position or from an employer) demonstrating strong work ethic which goes beyond the normal.

SECTION FOUR – Personal Statement:

In your own words, make a statement as to why you feel that the Selection Committee should give you consideration for this award. Your response should reflect your experiences in such areas as: serving others, meeting challenges, working hard to develop a better high school community.

______

THE ROTARY CLUB OF GRANDE PRAIRIE

ROTARY DISTRICT 5370

CHARTERED 1951

SECTION FIVE: Declaration of Applicant

I declare that I have answered all questions applicable to me and that all information is true and complete. I also grant permission for the selection committee to inquire into and receive information pertaining to my high school academic performance and my post-secondary enrollment status.

______

Signature of Applicant Date

NOTE: The decision of yourSchool Selection Committee will be final. All applications must be received prior to June 30. Forward application to:

Original:Your School Principal (Selection Committee)

Copy to:

Rotary Club of Grande Prairie

Scholarships Chair person

P.O Box 235

Grande Prairie, AB

T8V 3A4