“Service Above Self” Award Application – pg. 2 Student No. ______
For Rotary Use Only
Rotary Club of Steubenville, Ohio
District 6650. NO. 3609
P.O. Box 1485
Steubenville, OH 43952
“Service Above Self” Award
for High School Seniors
NOTE: Completed scholarship application must be received no later than Sunday, March 15, 2015, regardless of submission method used.
Place cursor on line to enter required information.
Student's Name:Home Address:
Home Telephone:
High School:
School Contact Person: / Phone:
Parents Names/Address:
Telephone Nos.(if different than above):
Please return the completed application according to the following guidelines:
1) Via link on Steubenville Rotary Club website.
Complete and submit: http://www.steubenvillerotary.com/sas-scholarship
2) Via an email attachment - Email the completed application to:
3) Via US mail - Send the completed application to: Christine Hargrave, P.O. Box 367, Toronto, OH 43964
Scholarship applications that are printed out and completed by hand must be completely legible.
Award will be given at the regular Rotary luncheon on Friday, April 10, 2015 at Noon. The recipient and parents will be invited to attend.
For Rotary Use:
This page of the application will be removed and retained by the Club Secretary prior to submitting the remainder of information to the judging panel of Rotarians.
Assignment of Student Number: ______
Rotary Club of Steubenville, Ohio
District 6650. NO. 3609
P.O. Box 1485
Steubenville, OH 43952
“Service Above Self” Award for High School Seniors
Insert cursor beneath each statement/question and enter completed, appropriate response.
Typing field will expand as necessary to accommodate amount of text entered. If you choose to handwrite or type, add additional sheets as necessary.
Please use relationship identifiers, ie: ‘brother”, “father” etc. vs “Charlie Brown” in place of specific family/associates names.
Please remember, the submissions are to be judged anonymously; so, no use of personal name(s), ie; signing/signature/proper names, is required through the remainder of this application.
1. DESCRIBE YOUR PROBABLE FIELD OF STUDY:
2. HOW MANY YEARS DO YOU EXPECT TO PURSUE POST HIGH SCHOOL EDUCATION (ie: 2,4,6,8 )
3. LIST (in order of preference) THE EDUCATIONAL INSTITUTIONS TO WHICH YOU HAVE APPLIED.
4. AS A FRESHMAN:
a) EXTRA CURRICULAR ACTIVITIES WITHIN THE SCHOOL (including offices held, letters won and recognition)
Please use a separate line for each activity.
b) COMMUNITY/CHURCH ACTIVITIES
c) FAMILY RESPONSIBILITIES (chores, obligations with siblings/parents, jobs):
5. AS A SOPHOMORE:
a) EXTRA CURRICULAR ACTIVITIES WITHIN THE SCHOOL (including offices held, letters won and recognition)
Please use a separate line for each activity.
b) COMMUNITY/CHURCH ACTIVITIES
c) FAMILY RESPONSIBILITIES (chores, obligations with siblings/parents, jobs):
6. AS A JUNIOR:
a) EXTRA CURRICULAR ACTIVITIES WITHIN THE SCHOOL (including offices held, letters won and recognition)
Please use a separate line for each activity.
b) COMMUNITY/CHURCH ACTIVITIES
c) FAMILY RESPONSIBILITIES (chores, obligations with siblings/parents, jobs):
7. AS A SENIOR:
a) EXTRA CURRICULAR ACTIVITIES WITHIN THE SCHOOL (including offices held, letters won and recognition)
Please use a separate line for each activity.
b) COMMUNITY/CHURCH ACTIVITIES
c) FAMILY RESPONSIBILITIES (chores, obligations with siblings/parents, jobs):
7. ESSAY
In a brief essay, describe your understanding of “Service Above Self” and how such service is reflected in your personal goals for the future. Please remember, the submissions are to be judged anonymously; so, no use of your personal name, ie; signing/signature/proper names is required throughout the application.
(If not using an electronic copy of this Application, please print it out and type, write very legibly or attach a word-processed response.)