Make a Difference Scholarship Application
This scholarship was established to encourage the pursuit of a post-secondary degree or certification by Circleville High School graduate. Applicants must be enrolled in or accepted by an accredited college, university, trade, technical, business, graduate, postgraduate or professional school. The scholarship(s) to be awarded next year will be $2,000. Disbursement will be made directly to the school after receipt of an official transcript of the student’s spring grades. Scholarship funds must be used in the following academic year. Please read criteria carefully to ensure application is complete and correct.
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.
Date of Birth
-
Month
-
Day
Year
Date
Circleville High School Graduation Date
GPA or class rank
Please indicate where you are employed and number of hours works per week. If not employed put N/A
School you will attend in the Fall of 2025.
Address of School (please make sure this is the exact name and address for which the payment will be made to the University or trade school if you are selected as a recipient)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Intended Field of Study
GPA (if currently enrolled)
Have you applied for or received other scholarships? If yes will they be renewed for this coming school year?
Will you be enrolled as a full time or part time student?
Applicant Interests and Goals
Please type your responses to the following questions in a separate document in 12 point font, double spaced and no more than one page for each question. Be sure to include your name and indicate topic #1, #2, #3: Topic #1: Briefly write about your involvement in your community, school, work, or another area that interests you. In addition, share something significant about your experience in that area. Topic #2: What Circleville High School Experience shaped you into the person you are today, explain? Topic #3: What are your goals and hopes for the future? Please include how you decided on this path, how you plan to make a difference, and if someone in particular has influences you along the way.
Please upload the essays for the above 3 questions. (Remember to put the # and your name on each of the 3 essays)
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Letter of Recommendation from someone unrelated to applicant that is a teacher, instructor, professor, or employer. If not enrolled in post-secondary program, high school teacher's letter will be accepted.
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Letter of Recommendation from an employer, coach, advisor, or clergyman.
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Please provide an up to date resume.
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Please provide a transcript from the most recently attended academic institution. Applicant must have a 2.5 cumulative grade point average or higher.
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Privacy Declaration: The information requested will be used to evaluate your application. None of your personal financial information will be divulged in any publicity or external parties. The information contained in my application for the Circleville City School Foundation Make a Difference Scholarship may be used by the Foundation for publicity purposes. Any exceptions are noted below.
Date Signed
-
Month
-
Day
Year
Date
Exceptions
I will notify Circleville City School Foundation immediately, in writing, of any change in plans to attend the school designated in my application.
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