Rotary International Super District 6400
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Rotary International Super District 6400
Trenton Rotary Club
P.O. BOX 161 • TRENTON • MICHIGAN 48183
Meetings: MONDAY Westfield Activities Center 12:00 P.M. 2700 Westfield • Trenton
TRENTON ROTARY SCHOLARSHIP APPLICATION POST-SECONDARY EDUCATION 2017
NAME:
ADDRESS: PHONE:
DATE OF GRADUATION:
COLLEGE, TRADE OR TECHNICAL SCHOOL CHOICE:
1 MAJOR:
2. MAJOR :
3. MAJOR :
FATHER'S OCCUPATION
MOTHER'S OCCUPATION HOUSEHOLD COMBINED INCOME: [ ] Under $25,000 [ ] $25-50,000
[ ]$50-$75,000 [ ] $70-100,000 [ ] Over $100,000
ACADEMIC INFORMATION: Use additional sheet if needed
CUMULATIVE GRADE POINT AVERAGE (4.0 GRADE POINT SCALE).
CLASS RANKING:
HIGH SCHOOL COUNSELOR' S NAME
EXTRACURRICULAR ACTIVITIES:
HONORS & AWARD:
ARE YOU A MEMBER OF THS INTERACT CLUB Y____ N____
OFFICES OR POSITIONS HELD:
YEAR JOINED:
EMPLOYMENT:
COMPANY NAME/YOUR POSITION:
SUPERVISOR'S NAME / PHONE #
EMPLOYMENT DATES:
AVERAGE HOURS PER WEEK: COMMUNITY INVOLVEMENT & VOLUNTEER ACTIVITIES:
SPECIAL INTERESTS AND ACTIVITIES:
OTHER FINANCIAL AID YOU EXPECT TO RECEIVE (SCHOLARSHIPS, GRANTS, LOANS)
TEACHER / COUNSELOR REFERENCES (MINIMUM OF 3: NAME, ADDRESS & PHONE#)
1.)
2.)
3.)
4.)
PERSONAL REFERENCES: DO NOT USE FAMILY / RELATIVES (MINIMUM OF 3: NAME, ADDRESS & PHONE #)
1.)
2.)
3.)
4.)
PLEASE WRITE A SEPARATE 500 WORD ESSAY DESCRIBING YOUR COMMUNITY ACTIVITIES, YOUR INTERACT INVOLVEMENT, IF A MEMBER, AND HOW THESE HAVE AFFECTED YOUR CAREER GOALS.
I ATTEST THAT ALL STATEMENTS I HAVE MADE FOR THIS APPLICATION ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
X-APPLICANTS SIGNATURE:
I ATTEST THAT ALL STATEMENTS MADE ON THIS APPLICATION ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
X-PARENT'S SIGNATURE:
ALL INFORMATION WILL BE KEPT STRICTLY CONFIDENTIAL THIS APPLICATION IS TO BE DOWNLOADED AND COMPLETED ON THIS FORM, THEN PRINTED IN HARD COPY. SIGN BY STUDENT AND PARENT. RETURN COMPLETED APPLICATION TO THE TRENTON HIGH SCHOOL COUNSELING OFFICE NO LATER THAN.
WEDNESDAY MARCH 1, 2017
For more information about The Trenton Rotary visit the web site www.trentonrotary.net