PEORIA PIONEER LIONS CLUB SCHOLARSHIP PROGRAM

In Honor of Lion Jenny Buckholz, Lion Jim Hunter, and Lion Frank Ryser.

2011 - 2012

The Peoria Pioneer Lions Club Scholarship Program consists of three scholarships (3) $1000. Will be awarded to three senior students who plan to continue their post-secondary education. The award will be payable to an educational institution identified by the recipient(s).

Directions: Applicant is required to type or word process all of the information on the application forms (additional pages may be attached and the application form may be re-keyed and completed using word processing software).

Submit the completed application package postmarked no later than March 9, 2012 to:

Peoria Pioneer Lions Club Scholarship Committee

8335 W. Audrey Lane, Peoria, Arizona, 85382

If you provide your email address, we will email you once your application has been received.

Submit the following as a completed application packet:

-Completed application form (all materials must be typewritten or word-processed, except signatures, transcripts, and letter of recommendation. No other handwritten information will be accepted.

-Official transcript (Must show previous five semesters) and a GPA of 3.0 or better.

-Letter of recommendation from two of your teachers.

-Essay describing your plans and how the scholarship will help you attain your goals.

-To volunteer for the Peoria Pioneer Lions Club to see what affect the Lions Clubs have on our community. The club does many community service projects all year long that you may pick from. Once application is received, someone from the club will contact you to talk to you about this part of the application.

All information must be completely filled out; any incomplete applications will not be considered. If any information is considered false, the application will be disqualified. Decisions of the Scholarship Committee are final.
2011 - 2012 Peoria Pioneer Lions Club Scholarship Application

  1. PERSONAL INFORMATION:

Name: ______Date: ______

Home Address: ______City: ______State: ____ ZIP: ______

Social Security Number: ______Home Phone: ______

School Name: ______

School Address: ______City: ______State: ______ZIP: ______

Date of Graduation: ______GPA: ______Email Address: ______

  1. LIST MEMBERSHIP ORGANIZATIONS (IN AND OUT OF SCHOOL).

Name of Organization/Serviceor Volunteering Provided Position Dates

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  1. COMMUNITY SERVICE

Lions Clubs around the world are all about community service. Tell us what you have done for your community, who it assisted, and how it has helped the community?

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  1. EDUCATION INFORMATION:

List the name, address, and your intended major of the post-secondary institution you plan to attend (state the date you will begin classes).

College Name: ______

College Address: ______

Major: ______Enrollment Date: ______

  1. ESSAY QUESTION (minimum 300 words).

Describe your plans and how the Peoria Pioneer Lions Club Scholarship will help, you attain your goals. (A separate sheet may be attached).

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Student’s Signature Date

Parent of Guardian Signature Date