Kiwanis Club of Bellingham
P.O. Box 902
Bellingham, WA 98227
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Bellingham Kiwanis 2015Scholarship Application
Criteria: Community Involvement, Academics, Leadership, Extra Curricular Activities, &
Special Circumstances
Application is for
Type of Program / Put an x for your choice4-yr College/University
Community College
Technical/Vocational School*
*Vocational Education: prepares trainees for jobs that are based on manual or practical activities, traditionally non-academic, and totally related to a specific trade, occupation, or vocation.
Submission:
Preferred: Email completed application to (Scan and submit documents.) or mail complete packet to Kiwanis Club of Bellingham, P.O. Box 902, Bellingham, WA 98227.
Scholarship applications must be received by April 30, 2015.
Applications received after this date will not be considered for scholarship.
Applicant’s Information –Please fill out on the table below.
NameTelephone
Address
High School
Bellingham Kiwanis--2015 Scholarship Application
Applicant’s Name
First / Last / Middle InitialFamily Information
Mother/Guardian / FatherName
Address (if different than applicant)
Occupation
High School Information
Cumulative GPA / Class Rank / SAT scoresReading / SAT scores
Math / SAT scores
Writing
College/Technical/Vocational Plans
Name of postsecondary SchoolAnticipated field(s) of study / 1.
2.
What are your goals?
Other Awards—List below the name & amount of any scholarships that you have.
Name of Award / Amount / Name of Award / AmountSchool activities: List all in which you have actively participated in during the past 4 years (e.g. student government, music, sports, clubs. Your list is limited to the space provided, so prioritize these that are relevant and important to you. If you “lettered” in your activity, indicate that by marking “L” rather than “x”
School Activity Grade Level of Participation Awards, Honors, Offices held.
Example activity / 9th / 10th / 11th / 12thExample activity / X / Secretary, 9th
Example sport / X / X / L / L / Team captain
Community service/volunteer activities—List those in which you participated without pay or school credit in the past four years. List the total number of hours for each activity. Do not include any time required for the culminating senior project or leadership class.
Volunteer Activities Grade Level of Participation Cumulative Volunteer Hours
9th / 10th / 11th / 12thLynden Library—Story time / 20 h. / 1 hour, twice a week for 10 weeks
List your paid work experience outside of the home over the past 4 years
Grade level / Employers(s) / Positions(s) held / StartingDate / Ending
Date / Total # hours
Personal Essay: Please answer the essay questions in the space provided below, approx. 2500 characters, including spaces. Do not include additional paper. We recommend typing in a word document, use grammar and spell check and then cut and past into this document.
Please write an essay in the space below describing yourself – family information, career plans, etc. Include a paragraph explaining your need for this scholarship.
Transcript and Test Information
- High School Transcript – Applicant must include a copy of a recent high school transcript, need not be official.
- Running Start Students – provide a recent transcript from your college, need not be official.
- Please provide a copy of your most recent SAT and/or ACT scores.
Please do not alter this scholarship form. It is important that you follow the application format as printed. Do not rearrange the format or the layout. Do not add-to or delete any part.
Scholarship applications must be received by April 30th.
Email to: (scan and submit appropriate documents
(or) mail to: Bellingham Kiwanis Club (Att: Scholarship Committee))
P.O. Box 902, Bellingham, WA 98227
I agree that when I am offered and accept a scholarship from the Bellingham Kiwanis Club, the club may use my name, photograph or likeness, the name of my community, the name and address of my school, the name and amount of the award and the name of the post secondary institution I am planning on attending in press release, public announcements, and other fundraising or promotional materials in all media to advance the non-profit objectives of the Bellingham Kiwanis Club.
I understand that I must be attending a technical, community or 4-yr college/university in the fall following my high school graduation. If I do not attend college, I understand that my scholarship funds will no longer be available. In the case of significant hardship, a recipient may appeal in writing to the awards committee, who may agree to a deferment.
Applicant Signature______Date______
Parent/Guardian Signature______Date______
School administrator/teacher______Date______
Application Checklist
This application for scholarship funds becomes complete and valid only when the following materials have been submitted to the Bellingham Kiwanis Club as a complete packet.
Submitted packet must be organized the following order:
- Scholarship application
- Current High School transcript (+ Running Start college transcript if applicable.)
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