Kiwanis Club of Granville
Scholarship Application
Student’s Name:__________________________________________Date:____________
(Please Print) Last First Middle
Home Address:___________________________________________________________
Street City State Zip Code
Home Phone:________________________ Cell Phone:__________________________
Email:____________________________________ Date of Birth:__________________
Cumulative G.P.A.:_______ Class Rank:____out of_____
Colleges Applied To: ____________________________
____________________________
____________________________
First Choice: ____________________________
Date of Proposed Entrance:___________ Field of Study:_______________________
Father’s Name:__________________________Occupation________________________
Home Address:___________________________________________________________
Place of Employment______________________________________________________
Mother’s Name:___________________________Occupation______________________
Home Address:___________________________________________________________
Place of Employment______________________________________________________
How many children in the family are not self-supporting?________ Ages:___________
How many will be enrolled in college next year?________________________________
I. Activities: Please list activities, achievements and awards you have received for the categories listed below. Please include the grade level in which you achieved this accomplishment. Use an additional sheet of paper.
School, Athletics, and Community Service
II. Leadership Positions: Please list on an additional piece of paper any leadership positions you have held:
School, Athletics, and Community Service
III. Awards, Honors, Recognitions: Please list on an additional piece of paper any awards, honors or recognitions.
IV. Work Experience: Please list any work experience on an additional piece of paper.
V. Projected costs:
Estimated cost (tuition, room & board) per year: $__________
How many dollars will the family contribute per year? $___________
How many dollars will the applicant contribute per year? $___________
How many dollars has the applicant already saved for college? $___________
From what other sources (scholarships, grants, loans, 529 plans, Coverdell IRAs, etc.) do you anticipate financial assistance?
Source:________________________Amount $__________ Renewable?___ Source:________________________Amount $___________Renewable?___
Please attach a copy of pages 1, 2, & 3 your FAFSE form.
VI. Essay: Please write and submit an essay not to exceed 250 words on the following subject: “My Plans and Goals for the Future Are”
VII. Essay: Please write a short essay not to exceed 100 words describing Kiwanis and identify some of the Granville Kiwanis projects.
VII. Recommendations: Please submit two letters of recommendation from schoolteachers or guidance counselors, advisors, employers, coaches or other adults who know you well. At least one of the recommendations must come from a teacher. Recommendations must be mailed directly to the Scholarship Committee.
VIII. Transcript: Please submit a copy of your transcript.
1/19/09
