The Little Elm Lions Club

The Little Elm Lions Club

P.O. Box 234

Little Elm, TX 75068

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LITTLE ELM LIONS CLUB

RULES AND REGULATIONS FOR

SCHOLARSHIP APPLICATIONS

Eligibility and Qualifications:

1. The applicant must be a currently enrolled LEISD Senior and scheduled to graduate in the Spring of the current year.

1. Scholarship payment is contingent upon acceptance by a College, University/Trade or Technical School and proof of applicant enrollment. It is the responsibility of the recipient to provide the necessary proof of enrollment.

1. The Lions Club MUST receive fully completed application and reference forms ALL AT THE SAME TIME no later than April 15, 2015. Lack of a complete application packet will disqualify any potential applicant from being considered.

1. Applications and all forms submitted with the application become the property of the Little Elm Lions Club.

1. All scholarship money must be spent by January 1 of the year following the award of the scholarship or it will be forfeited.

1. Community Service is the major focus of this Scholarship and is heavily weighted in considering the beneficiary of this Scholarship. Students must submit a signed log of all Community Service hours with their Application.

I have read and agree to the terms set forth by the Little Elm Lions Club. I understand that failure to follow these terms could result in forfeiture of any scholarship that I am awarded.

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Applicant SignatureDate

Please mail Application to Little Elm Lions Club, P.O. Box 234, Little Elm, TX 75068.

Questions may be directed to ______

NAME: ______

LASTFIRSTMIDDLE

ADDRESS: ______

STREETCITYSTATEZIP

HOME PHONE: ______CELL PHONE: ______

FATHER’S NAME: ______OCCUPATION: ______

FATHER’S PHONE: ______

MOTHER’S NAME: ______OCCUPATION: ______

MOTHER’S PHONE: ______

CHOICE OF SCHOOL (PLEASE CIRCLE)

1. ______APPLIED ACCEPTED NOT ACCEPTED

1. ______APPLIED ACCEPTED NOT ACCEPTED

1. ______APPLIED ACCEPTED NOT ACCEPTED

ANTICIPATED MAJOR ______MINOR ______

Have you been employed during high school? If so, briefly describe your job: ______

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As of the date of this Application, have you been awarded any Scholarships? If yes, please list source and amount.

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Applicant Name ______

On a separate piece(s) of paper, please answer the following questions:

1. Briefly, what would this scholarship mean to you? Any additional information or comments? (unusual family situations, medical expenses, etc.)
2. What are your personal and career goals?
3. Describe any obstacles/challenges that you have addressed during your high school career.
4. What subject, teacher or academic experience has had the most impact on you and why?
5. What does Community Service mean to you? Briefly describe your Community Service activities?

PARTICIPATION AND LEADERSHIP

School activities/Organizations/AwardsYear Office(s) Held or Honors

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Community Activities/Organizations/AwardsYear Office(s) Held or Honors

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Describe any honors not previously listed ______

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REFERENCES:

Please submit two references from LEISD counselors, teachers or administrators and one personal reference. Position/Relationship

1. ______
2. ______
3. ______

TO BE COMPLETED BY COUNSELOR (Upon review of the completed application).

THIS FORM SHOULD BE COMPLETED IN PRIVATE AND GIVEN TO STUDENT IN SEALED ENVELOPE.

Name of Applicant ______

Rank in Class: ______Grade Point Average: ______

SAT Score: ______ACT Score: ______

Counselor Comments: ______

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Counselor Signature: ______Date: ______