ROTARY CLUB - Brevard Public Schools
TITUSVILLE ROTARY CLUB
SCHOLARSHIP APPLICATION
2018 - 2019
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Service Above Self
“He Profits Most Who Serves Best”
In 1911, “He Profits Most Who Serves Best” was approved as the Rotary motto
at the second convention of the National Association of Rotary Clubs of America,
in Portland, Oregon
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ROTARY
Rotary International is a service club organization, with more than 1.2 million members in 33,000 clubs worldwide. Rotary club members are volunteers who work locally and internationally to combat hunger, improve health and sanitation, provide education and job training, promote peace, and eradicate polio under the motto, “Service Above Self”.
The object of Rotary is to encourage and foster service in five avenues of activity:
Club Service involves actions Rotarians take to strengthen fellowship and ensuring the smooth functioning of Rotary clubs.
Vocational Service is the way Rotary fosters and supports the application of the ideal of service in pursuit of all vocations. This may mean promoting the highest ethical standards in all occupations, recognizing the worthiness of all occupations and contributing one’s vocational talents to the problems and needs of society.
International Service International Service encompasses efforts to expand Rotary’s humanitarian reach around the world and to promote world understanding and peace. It includes contributing to Polio Plus, helping Rotary Youth Exchange students adjust to their host countries, and much more.
Community Service is the opportunity Rotary clubs have to implement club projects and activities that improve life in the local community.
New Generations Service recognizes the positive change implemented by youth and young adults through leadership development activities such as RYLA, Rotaract and Interact club service projects, and creating international understanding with Rotary Youth Exchange.
For more information about Rotary International, visit
For more information on the Titusville Rotary Club, visit
Our Address is: Rotary Club of Titusville, P.O. Box 1706, Titusville, FL. 32781-1706
We met at La Cita Golf & Country Club 777 Country Club Drive, Titusville, FL 32780.
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Dear Applicant:
The Titusville Rotary Club is actively involved in all areas of service throughout the North Brevard community. The provision of scholarships is one of several ways that Rotary clubs help meet the needs of our youth.
Scholarship applications must be returned to your Guidance Counselor by March 30, 2019. Interviews with finalists are generally held during the second week of April, with scholarships awarded in May at each of the High School Awards nights.
ELIGIBILITY REQUIREMENTS
1. The applicant must be a senior at Titusville, Astronaut or Space Coast High School(s).
2. This scholarship is expressly for use in the 2019-2020 school year at an accredited institution of higher education or accredited vocational training program.
3. A scholarship recipient must register as a full-time college student and maintain full-time student status during the 2018-2019 school year.
4. Family income of $75,000 or less. We will request a copy of tax return.
5. Other conditions and stipulations may apply. The Titusville Rotary club and Sunrise Rotary Club reserves the right to withdraw an awarded scholarship. All awards are subject to funding availability and other unforeseen factors.
APPLICATION INFORMATION
1. The Applicant must complete this form and return it to their Guidance Counselor.
2. The Guidance Counselor must attach the applicant’s transcript, test scores, GPA, and class rank to the application before submitting the packet to Rotary.
3. A parent or guardian must sign the form where indicated.
4. The deadline to submit an application packet is March 30, 2019. Incomplete application packets or materials received after this date will not be eligible for consideration.
5. Additionally, send notification to stallurirao@ that your application has been submitted to your Guidance Counselor (include your name, date submitted and name of Guidance Counselor) so that we may be assured that we receive all applications. If you cannot email, please contact Sudha Talluri-Rao at 321-474-0025 with this information.
6. Interviews are required of finalists.
7. The number of scholarships granted will be determined by the participating Rotary Clubs on an annual basis.
8. Scholarship awards will be sent directly to the designated college in September of the award year, following the applicant’s high school graduation.
9. Acceptance is not based on association with Rotary, Rotaract or Interact clubs.
10. Decisions of the selection committee are final.
11. Please attach additional pages as required when preparing responses.
12. Please attach a recent photo to your application.
13. Please attach a copy of your family tax return with your application.
For additional information, contact Sudha Talluri-Rao,
(Titusville Rotary Club). stallurirao@
[pic] Titusville Rotary
Scholarship Application - 2019
APPLICANT INFORMATION
HIGH SCHOOL ATTENDED: ________________________________________
NAME: ___________________________________________________________
STREET ADDRESS: ________________________________________________
City: ___________________________ST: _______ZIP CODE: ______________
DATE OF BIRTH: ______________ TELEPHONE: _______________________
E-Mail Address: _____________________________________________________
CLASS RANK: ________________ SAT: ________ ACT: ______
OVERALL GPA (WEIGHTED): ____ OVERALL GPA (UNWEIGHTED): ____
PARENT’S NAME/OCCUPATION: ___________________________________/_______________________________
PARENT’S NAME/OCCUPATION: ___________________________________/_______________________________
GUARDIAN’S NAME/OCCUPATION: ___________________________________/_______________________________
II. EDUCATIONAL ASPIRATIONS
A. List, in order of preference, your choice of college or university:
|College / University |Applied (Y/N)? |Accepted (A)/ Pending (P)/ Not Accepted(N/A) |
|1. | | |
|2. | | |
|3. | | |
B. What is your proposed major? __________________________________________
C. If you are undecided, please list your top three areas of interest:
1. _______________________________________________
2. _______________________________________________
3. _______________________________________________
III. FINANCIAL INFORMATION
What is your estimated budget for your first year of school:
Tuition _________ Books __________Fees __________
Room _________Board __________Other _________
Total Budget: __________
How do you intend to finance your college education? Please include expected parental/family contribution, personal contribution (work, etc.) scholarships and loans. Please be as specific as possible.
Please list those scholarships for which you have applied, and the status of each (i.e., awarded, denied, or pending).
|Name of Scholarship/Organization/Amount/Status | | | |
| | | | |
|__________________________________________________________ | | | |
|__________________________________________________________ | | | |
|__________________________________________________________ | | | |
| | | | |
| | | | |
How many people reside in your household: ________ .
Combined household income (income of parent(s)/guardian(s):
___ ≥ $75,000 ___ $60,000 – 69,000 ___ $40,000 – 59,000
___ $20,000 – 39,000 ___ < $20,000
Number of household members who will be attending college during the 2019-2020 school year: _____
Are there any unusual circumstances concerning your family’s financial situation that you would like to bring to the attention of the selection committee?
IV. ACCOMPLISHMENTS
List scholastic honors, awards, citations and achievements:
List school activities (clubs, sports, SGA, band, honor societies, etc.) where you were involved, as well as office(s) held during your high school years:
List (describe) community and volunteer activities involvement/accomplishments:
How many total hours of community service did you achieve during high school? Where were those hours spent?
Discuss your work history:
Other activities or recognition not listed above:
Rotary International President-elect Barry Rassin laid out his vision for the future of Rotary, calling on leaders to work for a sustainable future and to inspire Rotarians and the community at large. Rassin stressed the power of Rotary’s new vision statement, “Together, we see a world where people unite and take action to create lasting change — across the globe, in our communities, and in ourselves.”
V. ORIGINAL RESPONSE
Prepare and attach an original response to the topic, “How Does One Person Help To Make The World a Better Place - Not Just Here, Not Just for Us, But Everywhere, For Everyone, For Generations?” (Note: Your response may be conveyed through a written essay (between 250 – 500 words), poem, picture/collage, photograph, poster, cartoon/comic strip, or other creative medium.)
Submitted to Guidance Counselor with Requested Transcripts attached (Date: __________)
I have completed this application and I certify the information I have provided is truthful and accurate to the best of my ability and knowledge.
STUDENT SIGNATURE: ___________________________________________
Date: ___________________________
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I hereby give my son/daughter, ______________________________________, permission to apply for the Titusville Rotary Club Scholarship.
PARENT/GUARDIAN SIGNATURE: _________________________________
Date: ___________________________
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