Name of Scholarship:Rockland Hanson Rotary Club Scholarship Award- #66

The Rockland Hanson Rotary Scholarship program supports the mission of Rotary International, advocating service to the local, national, and worldwide community. Successful applicants will demonstrate active involvement in helping others, reflecting Rotary's Motto of Service Above Self.

Please fill this form completely. Type or write neatly in black ink.

Please include a transcript with this application.

Full Name: ______

Home Address: ______

Phone Number: ______

Email Address: ______

High School: ______

List three careers you could see yourself pursuing and explain your answer. (Attach an additional page if necessary)

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Colleges/postsecondary schools that you have applied to:______

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Colleges/postsecondary schools that you have been accepted to:______

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1st School Choice: ______Tuition: ______

2nd School Choice: ______Tuition: ______

List all scholarships, grants, and financial aid (with dollar amounts)that you have been awarded:

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How will you use this scholarship: Tuition______OR Tools/Equipment/Supplies______

Estimated parental contribution (EFC equivalent on FAFSA): ______

Estimated student contribution: ______

Anticipated financial needs: ______

Do you own a car? ______Will you commute to school? ______

Personal Information

Name of Father or Guardian: ______

Address: ______

Father's Occupation: ______

Employed by: ______

Name of Mother or Guardian: ______

Address: ______

Mother's Occupation: ______

Employed by: ______

Total number of persons dependent on parents (Include self & parents): ______

Names and ages of family members currently attending college or postsecondary school:

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Work Experience

List any paid work experience here.

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Service Based Selection Essay(An oral interview can be substituted by student request AND Guidance endorsement)*

Criteria For Scholarship Selection:

1. How closely a candidate demonstrates qualities that reflect Rotary International’s motto of Service Above Self.

2. Financial Need

Attach a one page typed essay. Talk about yourself and explainhow your achievements and goals demonstrate the Rotary International principles of service, community, and helping others. Be sure to include a description of any school, organization, and community volunteer activities; honors, prizes, or offices you have held. Additionally, please include any significant challenges you may have encountered and how the impact has affected you.

Statement of Applicant Support: I attest that I believe this applicant is deserving of consideration for the Rockland Hanson Rotary Club Scholarship.

Parent / Guardian Signature: ______

School Faculty/ Staff Signature: ______Title: ______

Please Be Aware: INCOMPLETE APPLICATIONS CANNOT BE CONSIDERED.

*Guidance Counselors must speak to their Rotary Club contact person to arrange for oral interviews before April 2, 2018