Oshkosh Southwest Rotary Scholarship Application

OSHKOSH SOUTHWEST ROTARY SCHOLARSHIP APPLICATION Scholarship Deadline: 2/22/16

1. APPLICANT INFORMATION

Name:______Student ID:______

Mailing Address: ______

City, State, Zip: ______

Telephone: ______Email: ______

2. FIRST YEAR COLLEGIATE ACADEMIC PERFORMANCE

Cumulative Grade Point Average: ______

*Attach copy of unofficial transcript

3. STUDENT WORK EXPERIENCE Most recent employer: ______

Job Title: ______Average Hours/Month: ______

From (month/year): ______To (month/year): ______

Next most recent employer: ______

Job Title: ______Average Hours/Month: ______

From (month/year): ______To (month/year): ______

4. COLLEGE INFORMATION Anticipated Undergraduate Major or Program of Study: ______

Type of School: Four-Year College or University Technical or Community College Junior College Other (Please specify: ______)

Level of Attendance: Full-Time Part-Time

Next year’s anticipated expenses at this school: Tuition: $______

Room & Board: $______

Books & Supplies: $______

Total: $______PLEASE PROVIDE THE FOLLOWING INFORMATION REFLECTING YOUR COLLEGIANT EXPERIENCE

5. CO-CURRICULAR ACTIVITIES (clubs, sports, student government, etc.)

Co-Curricular Activity Leadership Position (if any) Hours/Month Years Involved

______Fresh Soph Jr Sr

6. COMMUNITY VOLUNTEERISM (church, charity work, scouting, etc.) Volunteer Activity Leadership Position (if any) Hours/Month Years Involved

7. SCHOOL OR COMMUNITY AWARDS Award Awarded By Years Awarded

______Fresh Soph Jr Sr 8. 4-WAY TEST ESSAY Please write an essay to address the 4-Way Test that Rotary has adopted as the cornerstone of all its actions. Describe the benefit of the use of the 4 Way Test to a situation you have witnessed at your school, on the job or in the community? (Please limit your response to 2 pages)

9. DESCRIBE WHY YOU ARE DESERVING OF THIS SCHOLARSHIP

Scholarship Deadline: 2/22/16 Feel free to email any questions regarding the scholarship application and/or email your application to [email protected] or mail your completed scholarship application to: Oshkosh Rotary Southwest Attn Scholarship Committee PO Box 1202 Oshkosh WI 54903-1202