Cosmopolitan Club of Roanoke Scholarship Application Form

COSMOPOLITAN CLUB OF ROANOKE

Annual Track Meet Scholarship Program
This year The Cosmopolitan Club of Roanoke will award two $3,500 scholarships to a Senior High School male and a Senior High School female Cosmopolitan Track Meet participant that is pursuing further education after graduation. The scholarship proceeds are intended to be used exclusively for tuition expenses. The Cosmopolitan Club is an international service club and will consider each applicant’s record of service in awarding the scholarships. Financial need is not a consideration. Please refer to the procedure and eligibility requirements for further information.

Eligibility Requirements:

To apply, the applicant must be:
- A graduating high school senior that is participating in the Cosmo track meet.
- In the top 50% of your graduating class.
- Seeking to attend a college, university or other school of higher learning.
- Not related to any member of the Cosmopolitan Club of Roanoke.
Procedure:
1. Complete the application (below).
2. Be certain to include names and phone numbers of individuals that may be contacted to confirm your service in two areas – school and community service.
3. Complete the personal statement questions.
4. Upload at least one letter of recommendation.
5. Electronically submit your completed application by April 15, 2024.
6. The Award Date is May 4, 2024
For Receipt Of Scholarship Funds, The Recipients Must:
- Be enrolled in college, university or school of higher learning.
- Send a letter of notification by a qualified school official to the Cosmopolitan Club of Roanoke to confirm that enrollment has taken place and the student is attending classes.
- Upon confirmation, the scholarship check will be sent by the Treasurer of the Cosmopolitan Club directly to the institution on behalf of the enrolled recipient.
NOTE: BY SUBMITTING THIS APPLICATION FOR CONSIDERATION, THE APPLICANT UNDERSTANDS THAT ANY AND/OR ALL INFORMATION INCLUDED IS SUBJECT TO VERIFICATION AND THE APPLICANT AGREES TO COOPERATE IN VERIFYING THIS INFORMATION IF REQUESTED TO DO SO BY THE SCHOLARSHIP COMMITTEE.
I. Personal Information

Tell us about yourself
Full Name*

First NameMiddle NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mobile Phone*
Home Phone*
Email *
Where the confirmation will be send to
High School Now Attending:*
College Planning On Attending*
if undecided, please list potential schools.
High School Guidance Counselor Name*
High School Guidance Counselor Phone*
Please enter a valid phone number.
II. Personal Statement

Demonstrate service in the following areas: School and Community Service. (please complete appropriate sections on the following application) The applicant must complete a personal statement. If your submission is typed, it should be no longer than two pages, typed and double-spaced using 12-point type and one-half inch margins. Type the words “Personal Statement” at the top of each page, along with your first and last name. Clearly address the following three questions in sequential order, typing each question as it appears below. Type your response directly under each question.
1. Describe your most meaningful achievement(s) and how they relate to your field of study and your future goals. *
2 Tell us about a time you failed and what you learned from the experience. *
3. Describe a meaningful volunteer experience. *
III. School

Please detail your service at School. You must include the name and phone number of someone we may contact to ascertain each of your service activities (for example: a guidance counselor, teacher, a parent, a pastor/rabbi, employer, etc)
List activities, teams or organizations where you have served, activities performed and positions held for the past three years only.*
Contact Name*

First NameLast Name
Contact Phone Number*
Please enter a valid phone number.
2. Please list additional activities, teams or organizations where you have served, activities performed and positions held for the past three years only.*
2. Contact Name*

First NameLast Name
2. Contact Phone Number*
Please enter a valid phone number.
3. Please list additional activities, teams or organizations where you have served, activities performed and positions held for the past three years only.*
3. Contact Name*

First NameLast Name
3. Contact Phone Number*
Please enter a valid phone number.
IV. Community Service Details

Please detail your Community Service. You must include the name and phone number of someone we may contact to ascertain each of your service activities (for example: a guidance counselor, teacher, a parent, a pastor/rabbi, employer, etc)
Community Service: List organization(s) where you have served, activities performed and positions held for the past three years only. This can include community service organizations, non-profits, churches or service to family.*
Contact Name*

First NameLast Name
Contact Phone Number*
Please enter a valid phone number.
2. Additional Community Service: List organization(s) where you have served, activities performed and positions held for the past three years only. This can include community service organizations, non-profits, churches or service to family.*
2. Contact Name*

First NameLast Name
2. Contact Phone Number*
Please enter a valid phone number.
3. Additional Community Service: List organization(s) where you have served, activities performed and positions held for the past three years only. This can include community service organizations, non-profits, churches or service to family.*
3. Contact Name*

First NameLast Name
3. Contact Phone Number*
Please enter a valid phone number.
V. Letters of Recommendations

Please upload written letters of recommendation from the original sender in either PDF form, as a Word document or a legible image to be considered for the scholarship.
Recommendations File Upload*

Cancelof
Should be Empty:

COSMOPOLITAN CLUB OF ROANOKE

Eligibility Requirements:

Procedure:

For Receipt Of Scholarship Funds, The Recipients Must:

I. Personal Information

II. Personal Statement

III. School

IV. Community Service Details

V. Letters of Recommendations