APPLICATION FOR THE LIVINGSTON ROTARY CLUB SHIELDS VALLEY SCHOLARSHIP

NAME______

(First)(Middle)(Last)

ADDRESS______

(Street)(City, State, Zip)

BIRTHDATE EXPECTED GRADUATION DATE______

PARENT’S NAME(s)

(First) (Last)

PARENT’S ADDRESS (if different from applicant)

High School(s) attended other than ShieldsValleyHigh School: (If additional space is needed, use back.)

1)

(Name)(Address)(Date enrolled)

2)

(Name)(Address)(Date enrolled)

USING ADDITIONAL SHEETS OF PAPER, BRIEFLY DESCRIBE YOUR INVOLVEMENT IN AND YOUR PERSONAL BELIEFS ABOUT THE FOLLOWING AREAS:

1.SCHOOL AND RELATED ACTIVITIES (what type, when, and how you were involved)

2.YOU AND YOUR FAMILY

3.WORK/EMPLOYMENT EXPERIENCE (what did you do, when, and for whom)

4.YOU AND YOUR COMMUNITY (involvement in clubs, service groups, church, etc.)

In responding to this portion of the application, please describe how you believe your community involvement and service to the community shows your commitment to Service Above Self and the Rotary Four-Way Test which follows:

THE ROTARY FOUR-WAY TEST

of the things we think, say, or do

I.Is it the TRUTH?

II.Is it FAIR to all concerned?

III.Will it BUILD goodwill and BETTER FRIENDSHIPS?

IV.Will it be BENEFICIAL to all concerned?

5.HONORS RECEIVED AND OFFICES HELD (both in school and in the community)

6.LEISURE TIME ACTIVITIES

BRIEFLY DESCRIBE WHERE YOU PLAN TO ATTEND COLLEGE, WHAT AREA OF STUDY YOU WILL PURSUE, AND WHAT YOUR CAREER PLANS ARE FOR THE FUTURE.

A TRANSCRIPT OF YOUR GRADES AND STANDARDIZED TEST SCORES MUST BE ATTACHED. RETURN YOUR COMPLETED APPLICATION TO THE SHIELDS VALLEY HIGH SCHOOL GUIDANCE OFFICE BY APRIL 25, 2017.

LIVINGSTON ROTARY CLUB SHIELDS VALLEY SCHOLARSHIP

THE LIVINGSTON ROTARY CLUB SHIELDS VALLEY SCHOLARSHIP WAS ESTABLISHED NOT ONLY TO SERVE THE NEEDS OF THE INDIVIDUAL RECIPIENT BUT, ALSO, FOR SUCH SOCIAL OBJECTIVES AS INCREASING ACCESS TO COLLEGE FOR THE TALENTED, IMPROVING SOCIETY THROUGH THE EDUCATION OF ITS YOUNG PEOPLE, AND DEVELOPING MUTUAL APPRECIATION BETWEEN STUDENTS AND ADULTS IN THE COMMUNITY.

  1. The scholarship will be awarded in the amount of $500.00.
  1. The scholarship will be open to Shields Valley High School Seniors.
  1. The scholarship monies will be paid to the student in the form of a check made out to the registrar of the institution and the student. The Scholarship will be paid one-half at the commencement of the first semester, and one-half at the commencement of the second semester.
  1. The scholarship funds may be used for enrollment in any accredited college, university or vo-tech school, whether in or out of state.
  1. The recipient must be enrolled full time, and must present proof of enrollment to receive the Scholarship monies.
  1. The recipient must enroll in the institution during the school year following graduation from Shields Valley High School.

Rotary Scholarship Application

Shields Valley High School

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