
<p> TAOS LIONS CLUB SCHOLARSHIP APPLICATION</p><p>PERSONAL INFORMATION</p><p>Name ______Mailing Address: ______</p><p>Telephone: ______Email: ______</p><p>US Citizen__ Yes __No Gender M___ F___ Date of Birth ______</p><p>EDUCATIONAL INFORMATION</p><p>Graduate of ______High School, Date _____*GPA___ Score ACT ____SAT____</p><p>Names of schools to which you have applied: ______</p><p>Possible major(s)/field of study:______</p><p>Courses currently enrolled in:______</p><p>Courses desired next semester:______</p><p>*School Transcript Required</p><p>ACADEMIC INFORMATION: </p><p>Identify any current or previous education or work programs. Include name of activity/program/project, the sponsoring institution & approximate dates for;</p><p>STEM (Science, Technology, Engineering, Math) – ______</p><p>VOCATIONAL – ______</p><p>Academic Awards & Honors – list any special awards and honors you have received Career Goals: List your </p><p> Current career plans</p><p> Activities that support your goals</p><p> Where in New Mexico you intend to apply your skills</p><p>EXTRACURRICULAR ACTIVITIES</p><p>Activities, Sports, Clubs, Honors: indicate current or previous extracurricular activities, years of participation and the total number of hours spent on each activity</p><p>Employment History: Describe your employment history and the hours worked per</p><p> week in current and/or summer job.</p><p>Community Service: Indicate any current or previous community service activities sustained for a year or more, the nature of your involvement and the total number of hours spent on each activity. FINANCIAL NEED (OPTIONAL)It is recommended that applicants complete this section. If left incomplete, it will be assumed the applicant has no financial need. All information is kept confidential.</p><p>Family Income: Please check appropriate item</p><p>__ less than $30,000 __ $50,000 - $75,000 __ $100,000 +</p><p>__ $30,000 - $50,000 __ $75,000 - $100,000</p><p>Attach National Financial Student Aid Form (FAFSA)</p><p>Educational History: What is the highest level of the head of your family?</p><p>__ Did not finish high school __Completed four years of college</p><p>__ Completed high school (GED) __ Completed advanced degree</p><p>__ Completed two years of college</p><p>Family Background/Special Circumstances: One factor in the decision to award scholarship support is the your ability to overcome challenge. Please explain any special circumstances or challenges you and/or your family have faced.</p><p>APPLICATION PORTFOLIO REQUIREMENTS: A complete application portfolio will contain the following materials mailed to the Lions Scholarship Chair, PO Box 199, Taos NM, 87571 for review and selection by the Taos Lions Club Scholarship Committee;</p><p>1. Application form</p><p>2. Official academic transcript</p><p>3. Two letters of recommendation (one academic and one extracurricular) signed and in sealed envelops</p><p>4. An essay of approximately 250 words describing your personal objectives in pursuing a certificate, certification or degree.</p><p>5. National Student Financial Student Aid Form (FAFSA) 6. DEADLINE FOR SUBMISSION: April 08, 2016</p>
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