Pleasanton Rotary College Scholarship Application Form

2026 Scholarship Application

For College Sophmores, Juniors, Seniors, and Grad Students
All applicants must submit their application, transcripts, and FAFSA information prior to March 31, 2026. Deadline for submission is 12:00 midnight.

Scholarship candidates should complete all sections of the application along with transcripts from the last year of college you attended. Qualified candidates must have graduated from a sanctioned Pleasanton high school and are NOT dependents of a Rotarian. Financial need is the main criteria for selection for all scholarships.

Please type on this form and submit electronically. Any supporting documentation should be submilled electronically to The Rotary Club of Pleasanton, Scholarships@PleasantonRotary.org and cc a copy to gregorylkirk@gmail.com. By March 31, 2026.

If selected, you will 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. So, please use proper spelling, capitalization and punctuation.
I. Personal Data

Tell us about yourself
Student Name*

First NameLast Name
Birthdate*

MonthDayYear
Phone Number*
Alternative Number
Personal Email *
Where the confirmation will be send to. Do not use school email.
Permanent Address*

Street Address

Street Address Line 2

City

Zip Code
Student's 2025 Gross Income
Have you received a Rotary Scholarship previously?

YesNo
Amount of Scholarship
Year Received
II. WHO CLAIMS YOU AS THEIR DEPENDENT?
Financial Supporter 1
Name
Financial Suppoort 1's Relationship to you
Financial Supporter 1's Occupation
Financial Supporter 1's 2025 Income
Financial Supporter 2
Name
Financial Suppoort 2's Relationship to you
Financial Supporter 2's Occupation
Financial Supporter 2's 2025 Income
Who is helping you pay for your education?*

Explain the financial arrangements you have made with your support system.0/500
Are you or the people who claim you as a dependent involved in Rotary?

Pleasanton Downtown Rotary ClubNorth Pleasanton Rotary ClubRoteractOther Rotary Club
How will you pay for the balance of next year’s college costs that are not covered by scholarships or financial support from your family (which have been explained above)? Do you have savings? Will you work during college? Describe your financial need.*

0/500
III. BUDGET:

Detail your proposed expenses. Note that the total budget must be equal to the total financing of your scholarship grant amount. Attach any documents, such as price sheets or estimates, to support the expenses listed.
Please list the estimated cost of your education for the next school year using the table below.
- Enter amounts in U.S. dollars.
- Include only the listed expenses (tuition, required fees, books, and supplies).
- If you have already received other scholarships or grants, list them as a negative amount.
- Your Total Budget equals the amount you are requesting for this scholarship.
- You may attach supporting documents (such as tuition invoices, school fee schedules, or bookstore screenshots).

Anticipated Education Expenses*

	COST IN USD
Tuition & Required Fees
Books & Required Supplies
Less Scholarships & Grants Already Received (Negative Amount)
TOTAL BALANCE (Scholarship Amount Requested)

What other scholarships have you been promised or are still being considered for?

Provide the scholarship name, amount, and status for each scholarship.0/500
IV. PRIOR EDUCATION
Most recent College attended
Degree
Location
Field of Study
GPA
V. CAREER OBJECTIVES
In 200 words or less tell us about your objectives for the scholarship (program of study, degree sought, etc)*

0/200
VI. SCHOLARSHIP COLLEGE INFORMATION:

Provide the following information about the academic program you plan to attend:
Name of Institution

Street Address Line 2

CityState

Website
Academic Program

School Level in Fall

Program Start DateProgram End Date
YOU MUST BE ACCEPTED INTO THIS PROGRAM BEFORE WE WILL FUND YOUR GRANT. PLEASE SUPPLY A COPY OF THE ACCEPTANCE LETTER WITH YOUR APPLICATION AND A RECENT TRANSCRIPT.
List the classes you plan to take and provide relevant links to information about the program. Explain how the program and courses align with your future career plans.*

0/500
What are your long-term professional and/or academic plans immediately after the scholarship period (500 words or less)*

0/500
Helpful Hints:

Include addional pages if needed.

Email any backup to:

scholarships@pleasantonrotary.org

Or mail to:

Rotary Club of Pleasanton - Scholarships

PO Box 352

Pleasanton, CA 94566

YOU MUST INCLUDE A COPY OF YOUR CURRENT TRANSCRIPT.

DUE DATE IS MARCH 31, 2026 FOR ALL ATTACHEMNTS.
VI. Applicant's E-Signature
By signing the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
Signature*

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Pleasanton Rotary is committed to equal opportunity in employment and education. The organization does not discriminate in any program or activity on the basis of race, color, religion, gender, age, national origin, disability, marital status, or any other protected class.
Should be Empty:

2026 Scholarship Application

I. Personal Data

II. WHO CLAIMS YOU AS THEIR DEPENDENT?

III. BUDGET:

IV. PRIOR EDUCATION

V. CAREER OBJECTIVES

VI. SCHOLARSHIP COLLEGE INFORMATION:

YOU MUST BE ACCEPTED INTO THIS PROGRAM BEFORE WE WILL FUND YOUR GRANT. PLEASE SUPPLY A COPY OF THE ACCEPTANCE LETTER WITH YOUR APPLICATION AND A RECENT TRANSCRIPT.

Helpful Hints:

Rotary Club of Pleasanton - Scholarships

PO Box 352

Pleasanton, CA 94566

VI. Applicant's E-Signature