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Rotary Scholarship Application
For 2011-2012 School Year
Name:
Address: Phone:
City/State/Zip: Email:
High School:
Counselor's Name: Phone:
Graduation Date:
Central Community College System:
Hastings Columbus Grand Island Kearney Other:
North Platte (Mid-Plains Community College)
Area of Study (optional):
Please list 2 character references:
1) Name: Phone:
Address:
2) Name: Phone:
Address:
Please attach a letter explaining why you want to receive this scholarship.
Include any relevant material such as extra-curricular activities, class listing, letters of recommendation, etc.
Signature: Date:
Return requested materials to Rotary Scholarship - 206 E. 6th St. Kearney, NE 68847 by April 1, 2011.
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