Scholarship Application Form

SCHOLARSHIP APPLICATION FORM
Please read and follow the instructions carefully prior to submitting your application.

This form will not save, so please complete this form and please print out prior to closing the computer window.

All applicants will be notified by a Rotary Club Board Member of any scholarship award.
If selected, you may be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. Please use proper spelling, capitalization and punctuation.
I. Personal Data

Tell us about yourself
Full Name

First NameLast Name
Birthdate

MonthDayYear
Mobile No
Format: (000) 000-0000.
Email
Where the confirmation will be send to
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you a first generation college student?
II. Post High School Information
Major Area of Study
Please indicate what is your major are of study
Major Area of Study if not listed above:
Have you submitted an application for admission?
Have you submitted an application for admission?
College Accepted for Admission
If you are awarded a Rotary Club Scolarship, your Award will be sent to your College.

Please complete the informaion for your award.

If you do not have a College selected or College Student ID # yet, you will need to submit separatly your College Information when known. We want to ensure YOUR funds are posted to YOUR account correctly.
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
College Student ID # :
What amount of financial aid is expected or is already awarded to you :
$ Amount
If you are awarded a scholarship, would you prefer to turn in eligible receipts and have a refund sent to you directly from the Rotary Club? Note: Eligible items include computer-related items, books, college deposits/fees, and/or tuition assistance based on your scholarship award amount. Please note that your request is subject to final approval by the Rotary Club of Duncanville's Board of Directors.
III. Scholarship Essays
Why could this scholarship award be the factor of your ability to pursue a post-secondary education at this time?

0/200
Essay: Why is your post-secondary education important for your goals?

0/100
What is your post-secondary education college career objective and how would your post-secondary education degree benefit you?

0/100
IV. High School Information
Are you or will you be a high school graduate this year?
High School Attended
Year of High School Graduation or GED
Most recent cumulative GPA
Outside your daily academic classes, what extra high school activities, clubs, or offices have you held:

0/100
What outside school volunteer community activities are you involved in:

0/100
Outside of your school activities, do you have any paid or volunteer work experience:

0/100
V. Extra Consideration
Please check any of the qualifiers below that apply to you.
Do you plan to complete your two-year degree?
Do you plan to complete a 4-year degree?
Do you plan to complete a higher than 4-year degree?
Will you be working while attending College?
If Yes, will you work:
Would you be Interested in RotarACT, Rotary Internationals college student organization?
In addition to a scholarship award, would you like to be considered for any possible co-op employment opportunities? This co-op could be working with a local Duncanville company relevant to your major.
What might your Duncanville co-op work experience desire be:

0/100
VIII. Applicant's E-Signature
Signature
By signing the space, you are certifying that all information is correct and that you are the person completing this application.

Applications for consideration are normally accepted until April 30th of the current school year.

Awards are typically funded in the summer after application.

The Rotary Clubs Executive Board will make the final determinination of any awards granted.

Please print a copy for your records as verification of your application.

Please mail your printed application to:

Rotary Club of Duncanville

Attention: Scholarship Comittee Chair

P.O. Box 380837

Duncanville, TX 75138

Applicants may also hand-deliver a completed application at our regular Club Meetings, which are at 12 PM on Tuesdays at First Baptist Church of Duncanville.
Should be Empty:

SCHOLARSHIP APPLICATION FORM

I. Personal Data

II. Post High School Information

III. Scholarship Essays

IV. High School Information

V. Extra Consideration

VIII. Applicant's E-Signature