MORENO VALLEY ROTARY FOUNDATION

2016-2017 SCHOLARSHIP APPLICATION

The Moreno Valley Rotary Foundation will be awarding scholarships to one student graduating in June 2017from each comprehensive high school in Moreno Valley Unified School District (Canyon Springs, Moreno Valley, Valley View and Vista del Lago). Scholarships of $1,000 will be paid directly to the college or university financial aid office.

Criteria:

  1. Member of Interact for at least two years, including current year(preferred, but not required)
  2. GPA – Minimum of 2.50 (weighted)
  3. Graduating in the current school year

4.Plan to attend 4-year college/university in the fall (minimum of 12 units)

5.Two recommendations from former/current teachers (use the enclosed forms). List teachers.

6.Return all requested materials except teacher recommendation forms to your scholarship counselor or advisor no later than May 12, 2017. Please advise teachers who are completing recommendation forms to return them directly to your scholarship counselor or advisor by the deadline date. Teacher recommendations are not to be returned to you.

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Name of High School

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Student’s Name

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Student’s AddressCityStateZip

______M of F

Phone Date of Birth(circle one)

CRITERIA FOR SELECTION OF SCHOLARSHIP WINNERS

ValueCriteria

1.30%GPA

2.5%SAT/ACT Scores

3.15%Teacher Recommendations

4.10%Work Experience

5.20%Extra Curricular Activities

6.20%Community Involvement

*Counselor to attach official transcriptGrade Point Average (GPA) ______

STUDENT NAME: ______

EXTRA CURRICULAR/COMMUNITY ACTIVITIES AND HONORS

REPORTING FORM

Please enter a check ( ) in each box for the year(s) and semester(s) you participated in the activities listed. Enter information where requested and list awards and honors below (print as neatly as possible).

ACTIVITYSEMESTER

9th10th11th12th

Sem I Sem II Sem I Sem II Sem I Sem II Sem I Sem II

Student Government
Representative……….
Class Officer ………… / ( ) ( )
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Publications
Annual………………..
Newspaper………….. / ( ) ( )
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Athletics
Pep Squad………………….
Team Member……………..
Sport(s)……………………..
Team Mgr…………………..
Other______
______/ ( ) ( )
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Performing Arts
School Play______
Band ______
Choir / ( ) ( )
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Aerospace
Armed/Unarmed Drill......
Teams/Color Guard……….. / ( ) ( )
( ) ( ) / ( ) ( )
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( ) ( )
Scholastic Competition
(i.e. Academic Decathlon, History Day, Mock Trial, Forensics, Odyssey of the Mind, Etc.
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Clubs ______
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Work Experience
# of hrs. per week ______/ ( ) ( ) / ( ) ( ) / ( ) ( ) / ( ) ( )
Community Activities and Part Time Jobs
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______/ ( ) ( ) / ( ) ( ) / ( ) ( ) / ( ) ( )

STUDENT NAME ______

REPORT ALL AWARDS/HONORS EARNED:

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(Photocopies of certificates or recognition/awards may be attached. Do not submit original documents. Copies will not be returned.)

TEACHER RECOMMENDATION

Teachers:

______is applying for aMoreno Valley Rotary Foundation scholarship. We appreciate your thoughtful and candid assessment of this student. Your comments will be held confidential. Please return the recommendation to the guidance department scholarship chairman no later than May 10, 2017. DO NOT RETURN THIS DOCUMENT TO THE STUDENT.

Please place an X in the appropriate box.

Characteristics / Top 5% / Top 10% / Top 25% / Top 50%
Academic Achievement
Academic Potential
Motivation
Intellectual curiosity
Integrity
Creativity
Leadership Ability
Judgment & maturity
Positive self-image
Concern for others
Respect of faculty
Respect of peers
Sense of humor

PLEASE ADD COMMENTS: ______

______

______

You may add additional information. Please include the student’s name, your name and signature.

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Teacher’s NameTeacher’s SignatureDate

TEACHER RECOMMENDATION

Teachers:

______is applying for aMoreno Valley Rotary Foundationscholarship. We appreciate your thoughtful and candid assessment of this student. Your comments will be held confidential. Please return the recommendation to the guidance department scholarship chairman no later than May 10, 2017. DO NOT RETURN THIS DOCUMENT TO THE STUDENT.

Please place an X in the appropriate box.

Characteristics / Top 5% / Top 10% / Top 25% / Top 50%
Academic Achievement
Academic Potential
Motivation
Intellectual curiosity
Integrity
Creativity
Leadership Ability
Judgment & maturity
Positive self-image
Concern for others
Respect of faculty
Respect of peers
Sense of humor

PLEASE ADD COMMENTS: ______

______

______

You may add additional information. Please include the student’s name, your name and signature.

______

Teacher’s NameTeacher’s SignatureDate