Rotary Club of Clackamas

Ashley Wilks Scholarship

Requirements

  • Completed application
  • ClackamasHigh School senior
  • 3.0 minimum GPA preferred
  • Essay (See Part IV; attach to this application)
  • Two letters of recommendation (attach to this application) at least one letter coming from Clackamas High staff member.
  • Preference is given to those who are or have been involved in community service and have demonstrated leadership.

College Information

Specify your first choice only.

State______FullCollege Name______

Part I: Applicant Information

First Name______MI____Last Name______GPA___

Permanent Mailing Address______Apt.______

City______State______Zip______DOB:______

Home Phone______Cell______Email______

Part II: Activities

List activities in which you have participated during the last three years (school clubs, student government, publications, school or club sports,arts, 4-H, Scouting. Please do not use acronyms.

Activity Description / Years Involved / Highest Position Held

Part III: Community Service

List community agencies or organizations in which you have participated WITHOUT PAY during the last three years (for example: religious groups, hospital volunteer, cultural activities, outreach programs.). Indicate the total amount of hours during the past three years. Please do not use acronyms.

Volunteer Activities / # Hours

Part IV: Essay

Write a two-page, double-spaced 12-point Times New Roman essay (attach to this form). Applicant is to integrate the topic of world peace into the current year’s theme of Rotary International. (2012 = Reach Within to Embrace Humanity) Also in the essay, please express goals for the future and how college will help achieve those goals, and why you believe you are a good candidate for this scholarship.

APPLICATION CHECKLIST

You may use the following checklist to ensure the application process is complete.

All documents must arrive in the same package for the submission to be considered complete. Incomplete applications will not be considered.

__ I have completed the two-page application.

__ I have all required signatures on this application.

__ I have attached my completed essay.

__ I have attached two letters of reference.

__ I have photocopied my entire submission for my files.

CERTIFICATION

I certify, to the best of my knowledge, that the information on this application is complete and accurate. Falsification of any information will cause my disqualification from the scholarship competition.

I understand it is my responsibility to ensure this application is complete and mailed by the required postmark deadline listed on the application. Furthermore, I understand that if my application is not complete, or if I do not submit my application by the postmark deadline, I may be disqualified from the scholarship competition.

This application, upon receipt, becomes the property of the Clackamas Rotary and of ClackamasHigh School.

Applicant’s Signature______Date______

Parent’s Signature______Date______

(If the student is under 18 years old)

FINANCIAL AWARD: Funds will be distributed to the scholarship recipient’s college/university and the school will then credit the student’s account toward books and/or tuition.