UPPER KEYS ROTARY
SCHOLARSHIP APPLICATION
FOR GRADUATING SENIORS
Submission Deadline: Midnight: April 16
– NO EXCEPTIONS-
If you fail to fully complete the application, your application is at risk of being denied. If you fail to complete any portion of the application, please explain why.
If you have questions, please see the helpful YouTube video by typing keysrotary.info into any browser
Name:
Phone Number:
Address 1:
Address 2:
City / State/ Zip:
Email:
Please answer all questions completely and fill out the financial form for numbers 4, 5 & 6. Once the document has been completed, print out a paper copy and be sure your parent and/or guardian has signed the appropriate areas. Please submit via email to:
or mail to:
Upper Keys Rotary Club Scholarship Committee
PO Box 1514,
Tavernier, FL 33070.
If you email the application and do not receivewritten confirmation please contact Marlo DeMoss at 305-394-1880 to confirm receipt.
1)To which colleges/vocational schools have you applied?
2)Of those, which ones have accepted you?
3)What are your educational goals and career objectives? (State briefly. Expand in your essay. "Undecided" is a perfectly good answer.
4)What are the estimated costs of your education? (Tuition, Room & Board, Other)
Please answer by completing the financial analysis sheet on the final page of this form. Note that each college or university Website usually has a section on cost of attendance. Other cost estimators are available.
5)How will you pay for your education? Be specific, including scholarships already received, grants, loans, etc. Please put information on cost spreadsheet. Note applications will NOT be accepted without financial information.
6)How much do you expect to receive in family contributions toward your education? (This also includes: Florida Pre-paid, Trust Accounts, Education IRA, 529 Plan, etc.)
7)There are 2 levels of consideration for each scholarship: merit and need. Most awards are primarily based upon financial need. Please provide us with a verifiable household income and family size. Additional financial documentation might be requested.
Total annual household income:Number of people in family:
Under $25,000 [ ]______
$25,000 - $50,000 [ ]
$50,000 - $75,000 [ ]
$75,000 - $100,000 [ ]
$100,000-$150,000 [ ]
Over $ 150,000 [ ]
8)Do you have a special financial need or family situation, which will assist us in our evaluation? If so, please explain in a separate section.
9)The Free Application for Federal Student Aid (FAFSA) is a required part of the Rotary Scholarship application. You often complete this form as part of the college/university financial aid process. You can register and see your FAFSA information at . (Note: this is a free US Government Website. Be careful because there are other sites that charge you for the same free process.) We ONLY need a copy or image of the page providing the "Expected Family Contribution" or EFC score. Attach a copy or image of the page with the EFC score to this application. Examples are shown on the video online at keysrotary.info
10) Are you a Take Stock In Children recipient? Yes _____ No _____
11)What are your SAT and/or ACT scores? (List only the highest score in each)
SAT (verbal: ______) (math:______)ACT Overall Score: ______
12)Have you ever held a job? Yes ______No ______
If you have, please list your employers. If you have not, please state the reason(s) why.
13)In what activities did you participate?
a) School
b) Other
14) In what volunteer/community service activities did you participate?
15)What leadership positions have you held at school or in the community?
16)Why should you receive this scholarship? You may answer this question in the essay below.
17) Writea brief essay about the person or experience which has instilled in you the desire to pursue a college education. You may use page 6 below or attach on a separate page.
18)References: Please list three persons, other than relatives, who have knowledge of your background and character.
- Name:
Phone #:
Email:
- Name:
Phone #:
3. Name:
Phone #:
19)Attach at least one letter of recommendation.
Questions? Most questions are answered in the video available at keysrotary.info You may send email with specific questions to: UKRotaryScholarship@gmail.
Change email address?Please let us know by emailing us at
STUDENT: By entering my name below, I certify that all information stated in this application is accurate:
Please Print name: ______
STUDENT NAME ______College/ Vocational School______
Year 1
/Year 2
/Year 3
/Year 4
ESTIMATED COSTSTuition
/ $ / $ / $ / $Room and Board / $ / $ / $ / $
Books & Supplies / $ / $ / $ / $
Travel & Miscellaneous / $ / $ / $ / $
Total Cost
/ $ / $ / $ / $SOURCES OF CASH
Florida Prepaid
/ $ / $ / $ / $Bright Futures / $ / $ / $ / $
Scholarship 1 / $ / $ / $ / $
Scholarship 2 / $ / $ / $ / $
All Other Scholarships / $ / $ / $ / $
Dollars from Savings / $ / $ / $ / $
Dollars from Parent/Relatives
/ $ / $ / $ / $Dollars from Working / $ / $ / $ / $
Dollars from Loans
/ $ / $ / $ / $Other
/ / / $ / $ / $ / $Total Sources
/ $ / $ / $ / $Estimated Shortfall
(Costs minus Sources) / $ / $ / $ / $**Be as specific as possible. Years 2 through 4 can be estimated as equal to Year 1 if you expect no changes in circumstances. If you have not yet committed to a specific school, please complete this form for each school you are considering.
Parent/Guardian: By entering my name below, I certify that all financial information stated in this application is accurate:
Please Print name: ______
You may use this page to write your essay or you may attach a separate sheet:
Student Name: ______