Form
CLEAR LAKE SHORES CIVIC CLUB APPLICATION FOR SCHOLARSHIP 2023
Date
-
Month
-
Day
Year
Date
What type of school do you plan to attend?
Trade/Vocational/Technical
Junior College
University
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Have you resided in Clear Lake Shores for both your Junior and Senior HS years? (Proof of residence required)
Yes
No
What was your Junior year grade point average? (proof required)
What is your Senior year grade point average? (proof required)
What community activities are you involved in?
What school activities are you involved in?
What High School are you presently attending?
Date you will graduate:
School of higher education that you plan to attend:
School address and telephone number:
Have you been accepted at the school you plan to attend?
Yes
No
Will you be a full time or part time student?
Full time
Part time
Parent's Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Is your family a resident of Clear Lake Shores or Lazy Bend?
Yes
No
Has your family been a member of the Civic Club for at least one (1) year?
Yes
No
Please submit an essay below stating what this community means to you, and any other information you believe would be helpful to the Clear Lake Shores Civic Club Scholarship Foundation.
Signature
DEADLINE FOR SCHOLARSHIP APPLICATION: May 15, 2023(Applications received after the deadline will NOT be considered)
Submit
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