THE ROTARY CLUB OF LAWRENCEBURG - anderson.k12.ky.us



THE ROTARY CLUB OF LAWRENCEBURG

Service Above Self-He Profits Most Who Serves Best

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THE LAWRENCEBURG ROTARY CLUB SCHOLARSHIP

$2000

SCOPE AND PURPOSE

This scholarship is awarded to an Anderson County resident who is enrolled as a high school senior, a college, vocational or technical student or graduate or anyone seeking additional formal education. Recipients of other scholarships shall be eligible for the Rotary Scholarship.

All applicants must complete a Rotary scholarship application to be considered. Scholarship applications may be obtained from the guidance office at Anderson County High School and must be completed and submitted to the counselor before April 8th.

A Scholarship Committee of the Lawrenceburg Rotary Club will review each application to determine the scholarship recipient.

The Rotary scholarship will be awarded to the person who, upon determination by the Scholarship Committee, embodies a balance of excellence in such areas as academics, responsibility, social involvement and moral integrity. This person should exemplify qualities that would insure them to be a conscientious citizen and an asset to any organization or community in the future.

DEADLINE: APRIL 10, 2015

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THE ROTARY CLUB OF LAWRENCEBURG

Service Above Self-He Profits Most Who Serves Best

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APPLICATION FOR SCHOLARSHIP

Full Name _________________________________________________________________________

(last) (first) (middle)

Home Address ______________________________________________________________________

City ___________________________________________ State ______Zip______________

Date of Birth __________________________ Phone No. ____________________________

Marital Status _________________________ Male _____________ Female_____________

Name of Parent or Spouse ____________________________________________________

Consent For Release of Student Information

I hereby give my permission to the Rotary Scholarship Committee to review my scholastic record or any other information necessary for consideration of this scholarship award. Should I be selected for this award, the Rotary Club has my consent to publicly announce this achievement and make further use of any promotional benefits of this event.

Signature of Applicant______________________________________________Date__________

Parent’s Signature _______________________________________________________________

(if applicant is under age of 18)

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INFORMATION PROVIDED BY SCHOOL OFFICIAL

GPA ___________

Remarks of Counselor, Principal, or Dean:

In comparison with other students whom you have known at comparable stages of their careers, how would you rate this applicant in the following areas? If you are unable to evaluate an area, please leave blank.

Excellent Good Average Below Average

Leadership __________ __________ __________ __________

Initiative __________ __________ __________ __________

Enthusiasm __________ __________ __________ __________

Adaptability __________ __________ __________ __________

Maturity __________ __________ __________ _________

Seriousness of Purpose __________ __________ __________ _________

Emotional Stability __________ __________ __________ _________

Communication Skills __________ __________ __________ ________

Signature _____________________________________________Title _________________________

(School Official)

Please Print Name ___________________________________________________________________

Please include any additional information or comments that you feel should be considered in evaluating this candidate. Page 4 of 4

EDUCATIONAL INFORMATION

Current Status (check one):

_____________ High School Senior or Graduate

_____________ College Student

_____________ Other (explain) _____________________________________________________

From what high school did you or will you graduate? ____________________________________

Graduation Date: (Month/Year) _____________________________________________________

Please indicate post-high school study if any, including institution, date attended and degree.

_______________________________________________________________________________

Graduation Date (Month/Year)______________________________________________________

At which institution, college or university do you plan to enroll?

Name_______________________________City_____________________State ______________

Term for which you are applying ____________________________________________________

Please list vocational preferences:

A _________________________ B ________________________ C ________________________

Provide the following information on separate pages:

A. A list of any Honors, Awards, and extra-curricular/co-curricular activities.

B. In a brief statement, explain why you feel qualified to receive this Rotary scholarship.

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ACT Test Scores: Composite Score__________

English ___________ Math__________ Reading ___________ Science Reasoning __________

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