The University of Georgia Foundation
4502150-22796500-3175-28511500Rincon Noon Lions ClubScholarship Application$500With 46,000 clubs and 1.4+ million members, Lions Club is the world’s largest service club organization. Our members do whatever is needed to help their local communities. Everywhere we work, we make an impact; with children who need eyeglasses, with seniors who don’t have enough to eat and with people we may never meet. Our mission is to serve communities, meet humanitarian needs, encourage peace and promote international understanding through Lions clubs.The purpose of this scholarship is to foster the humanitarian spirit of a deserving senior who has an interest in optometry and/or pediatric care and will be attending any two or four year college or technical school. Our intent is to reward students with a strong motivation to succeed and who have already demonstrated a level of community service or community impact. Grade point averages and highest SAT score are for informational purposes only.Please use this page as a cover sheet with your name, address, and phone number stapled to the top of the rest of your application. Name:___________________________________________________________Address:_________________________________________________________Phone:___________________________________________________________High School:______________________________________________________Rincon Noon Lions ClubScholarship GuidelinesA $500.00 Scholarship will be awarded to two (2) students from each area high school (ECHS/SEHS) on the basis of need, character, academic performance and all around sincerity of purpose.All applications must be completed and received in the counselors’ office byFriday, May 4, 2018.Scholarships will be recognized at each high school’s respective Class Night. The winning recipients will have the scholarship funds paid directly to the school of their choice.Each application is to be accompanied by three letters of recommendation; at least one being from school personnel and one from someone in the community.Applications may be printed from the high school website and returned to the Counselors’ office at Effingham County High School or South Effingham High School.Please write an essay describing your humanitarian spirit and community service impact that incorporates the following information: your involvement in school and out of school activities, whether or not you have worked or are currently working, your accomplishments and your dreams. What is your vision for yourself in the field of optometry and/or pediatric care? Why did you choose this field of study? (Essays must be typed.)Application for Rincon Noon Lions Club ScholarshipPersonal Data: Last Name: First Name: Middle Initial:Date of Birth: / /Age:Sex: Address: Phone Number: 200406054292500288099554292500407289054292500Family Data:FatherStep-fatherGuardian (Check One)Name: Address: Occupation: Employer: 338757011862002107409118620011417891993700Mother Step-mother Guardian (Check One)Name: Address: Occupation: Employer: ANNUAL GROSS FAMILY INCOME BEFORE DEDUCTIONS (Check one):18319756032500Under $15,000183197512827000$15-20,000183197512954000$20-25,000$25 -30,0003969385-16002000396938512827000$30 -40,000396938512954000Over $40,000Brothers’ Names Sisters’ Names Age: _____________ Age: Age: _____________ Age: Age: _____________ Age: Age: _____________ Age: Age: _____________ Age: Age: _____________ Age: Persons other than those already named who also reside in your home:9872513660900320103523241000382714523241000Is another member of your family attending college, technical school, nursing school or other post-high school training program?YesNoIf yes, please explain.1073517376800178625540576500241427040576500Within the last five (5) years, have there been any unusual circumstances in your family that have created extreme financial difficulty such as an extended illness, accidents, physical disability, etc?YesNoIf yes, please explain.642195486100Education/Career GoalsWhat is your current grade point average and what is your highest SAT or ACT score?1246038814500What school are you interested in attending and why? Have you already been accepted?12460414836100Give a brief statement of your intended major course of study and your career plans upon graduation from college.11112514033500ActivitiesIn what community activities or projects have you recently taken part? What was your role in each?1460509906100In what school activities or projects have you recently taken part? What was your role in each?1277196710700List all significant extra-curricular activities in which you have engaged in while in high school:1746258890000Are you currently employed? If so, where?1449719100900Signature of ApplicantDate _______________________________________________________________________________Signature of parent or guardianDate________________________________________________________________________ ................
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