<p> OSHKOSH SOUTHWEST ROTARY SCHOLARSHIP APPLICATION Scholarship Deadline: 2/22/16</p><p>1. APPLICANT INFORMATION</p><p>Name:______Student ID:______</p><p>Mailing Address: ______</p><p>City, State, Zip: ______</p><p>Telephone: ______Email: ______</p><p>2. FIRST YEAR COLLEGIATE ACADEMIC PERFORMANCE</p><p>Cumulative Grade Point Average: ______</p><p>*Attach copy of unofficial transcript</p><p>3. STUDENT WORK EXPERIENCE Most recent employer: ______</p><p>Job Title: ______Average Hours/Month: ______</p><p>From (month/year): ______To (month/year): ______</p><p>Next most recent employer: ______</p><p>Job Title: ______Average Hours/Month: ______</p><p>From (month/year): ______To (month/year): ______</p><p>4. COLLEGE INFORMATION Anticipated Undergraduate Major or Program of Study: ______</p><p>Type of School: Four-Year College or University Technical or Community College Junior College Other (Please specify: ______)</p><p>Level of Attendance: Full-Time Part-Time</p><p>Next year’s anticipated expenses at this school: Tuition: $______</p><p>Room & Board: $______</p><p>Books & Supplies: $______</p><p>Total: $______PLEASE PROVIDE THE FOLLOWING INFORMATION REFLECTING YOUR COLLEGIANT EXPERIENCE</p><p>5. CO-CURRICULAR ACTIVITIES (clubs, sports, student government, etc.)</p><p>Co-Curricular Activity Leadership Position (if any) Hours/Month Years Involved</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>6. COMMUNITY VOLUNTEERISM (church, charity work, scouting, etc.) Volunteer Activity Leadership Position (if any) Hours/Month Years Involved</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>7. SCHOOL OR COMMUNITY AWARDS Award Awarded By Years Awarded</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______Fresh Soph Jr Sr</p><p>______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)</p><p>9. DESCRIBE WHY YOU ARE DESERVING OF THIS SCHOLARSHIP</p><p>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</p>