Lake San Marcos Kiwanis Club Foundation

Application for College Scholarship

1030 La Bonita Drive, Suite 342

San Marcos, CA 92078

Submission Requirements:

1.  All submitted material must be typed-word processed, double spaced, & a minimum of 9 point common font.

2.  MUST submit an autobiography & essay (3 Page per item limit)

3.  Up to two (2) letters of recommendation

4.  Transcript of credits with school verification

5.  Legal Residence required

Name______

Address______Phone#______

E-mail______Cell Phone#______

City______State____Zip______

  1. Legal Resident? Yes___ No____
  1. What is your GPA? Weighted__ Un-weighted__
  1. What College are you planning to attend ______
  1. What is your choice of College Major ______
  1. High School Attended

______

  1. Please list any Honors and Award received (Use separate sheet/s if needed):
  1. Briefly describe any Community Involvement, Public Service, and/or Related Activities (Use separate sheet/s if needed):

7a. Complete this section ONLY if a Kiwanis Key Club Member—Ruth Underwood Scholarships limited to Key Club members.

List the name of your club, years of membership, offices held, and/or other Key Club activities.

______
______

  1. List any extra-curricular activities, including year of participation and/or any offices held or other responsibilities (Use separate sheet/s if needed):
  1. List your employment experience—part time, summer jobs, internships, etc (Use separate sheet/s if needed):

______
______

______

  1. List all other Scholarships applied for and/or received.

______
______

  1. ESSAY Section: In your own words, please describe briefly why you desire to be a recipient of a Lake San Marcos Kiwanis Club Foundation Scholarship.

(Please submit on separate sheet/s in a typed-word processed format.)

PARENTAL FINANCIAL DATA

(Students please Note: If you have a FAFSA application on file, it can be used in lieu of the financial data requested below)

Income Amount Expenses Amount

Father’s Net Income $______Uninsured Medical Expense $______

Mother’s Net Income $______Child Care $______

Other Taxable Income $______Other $______

Other $______Other $______

Please list the number of dependents claimed as Tax Deductions:

Last Year______Current Year______

Number of these dependents that will be enrolled in college in the fall? ______

I (we) certify: That all the information given on this application is true & completed to the best of my/our knowledge.

I (we) understand that the data requested in this application is confidential. I (we) authorize ______High School or College to release enrollment & financial data to any agency to whom I have applied to for assistance.

Applicants Signature______Date______

Parent’s Signature______Date______

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