M e s q u i t e R o t a r y C l u b
PO Box 851947
Mesquite, Texas 75185-1947
Scholarship Application
GENERAL INFORMATION
Name: ______Phone: ( )______
Address:
Street and Number City Zip
Are you a citizen of the United States: Date of Birth:
FAMILY GROSS ANNUAL INCOME
$0–40,000 $40,001–65,000 $65,001–90,000 over $90,000
EDUCATIONAL INFORMATION
High School currently attending:
High School Counselor:
Date of High School Graduation:
SAT Scores: Reading:__ Writing: Math:
ACT Scores: Language:______Reading:__ Math:____ Science:______
Current GPA: Class Ranking:
Institution of higher education you plan to attend:
Have you been accepted: Yes No Major: Minor:
Give a description of your academic history:
Give a description of your extracurricular activities:
Give a description of your community service activities:
Is there any possibility that you will be offered a full scholarship from the institution of higher learning you will be attending: Yes No
SHORT ANSWER QUESTIONS
Please provide your long-term career goals:
Please give rationale supporting your belief that you would be an appropriate recipient of this scholarship:
______
Please provide comments supporting your financial need for this scholarship:
Signature ______Date ______
APPLICATION DEADLINE: April 11, 2014
This application must be returned in Word format, via email to
or mailed/delivered to:
Evelyn Williams
924 Military Parkway
Mesquite, TX 75149
This is the complete Application. No other information is necessary or desired.
Best wishes!
Mesquite Rotary Club – Scholarship Application – Page 1 of 2