Fort Gratiot Rotary

FORT GRATIOT ROTARY

Dorothy E. McLean Memorial Scholarship

FOR CONTINUING EDUCATION

APPLICATION FORM

Applicant Name: ______

Street Address / City / Zip: ______

Phone Number(s): ______

Date of High School or General Education Diploma: ______

College of Choice: ______

College Course(s) Enrolled In: ______

Avg. # of Credits per Semester: ______

Current College GPA: ______

Place of Employment (if applicable):______

# of Hours in Average Work Week: ______

Preferred Interview Days / Times: ______

By signing this application I am certifying that the information contained herein is accurate. In addition, I state that I am not a Rotary member, nor am I related in any way to a Rotary member.

Applicant Signature______Date______

Items to present with application:

Letter of recommendation from employer or a one page essay explaining the applicant’s desire to return to college and their degree choice

Proof of employment – including # of hours (full time or part time if applicant is employed)

Copy of current semester registration form from college (verifying enrollment, # of credit hours, etc)

Copy of driver’s license

Applications must be completed by December 1 for winter term and

June 1 for fall term

Mail to:

Rotary Club of Fort Gratiot

Scholarship Committee

ATTN: Nancy Klemmer

PO Box 595832

Fort Gratiot, Michigan 48059