Scholarship Application

STUDENT’S FULL NAME

ADDRESS

E-MAIL ADDRESS

S.S. #

HIGH SCHOOL ATTENDED/ATTENDING

BIOGRAPHIC INFORMATION KIWANIS CLUB OF GREATER BRANDON ANNUAL SCHOLARSHIP

The information requested in the application form will assist the Scholarship Advisory Committee to determine your qualifications for a Kiwanis Club of Greater Brandon Scholarship. Therefore, it is your advantage to give as complete and accurate answers as possible to all questions.

The answers will be seen only by authorized persons who are concerned with this Scholarship program, and will be held in confidence by them.

ADDITIONAL BIOGRAPHICAL INFORMATION

What Community college or University do you plan to attend?

Have you been accepted at this college/university as of this date?

DATE

I certify that the following information is accurate to the best of my knowledge.

SIGNED BY: STUDENT:

EXTRACURRICULAR AND PERSONAL ACTIVITIES

Please list your principal extracurricular and community service activities in the order of their interest to you. For example honor societies, clubs, etc.

Activity (1)

Grade level or year of participation

9
10
11
12

Approximate number of hours spent per week (Activity 1)

Positions held or honors won (Activity 1)

Activity (2)

Grade level or year of participation (Activity 2)

9
10
11
12

Approximate number of hours spent per week (Activity 2)

Positions held or honors won (Activity 2)

Activity (3)

Grade level or year of participation (Activity 3)

9
10
11
12

Approximate number of hours spent per week (Activity 3)

Positions held or honors won (Activity 3)

Activity (4)

Grade level or year of participation (Activity 4)

9
10
11
12

Approximate number of hours spent per week (Activity 4)

Positions held or honors won (Activity 4)

Activity (5)

Grade level or year of participation (Activity 5)

9
10
11
12

Approximate number of hours spent per week (Activity 5)

Positions held or honors won (Activity 5)

WORK EXPERIENCE

Please list any job (including summer employment) you have held during the past three years.

Specific nature of work (1)

Employer (1)

Approximate date of employment (1)

Approximate number of hours spent per week (1)

Specific nature of work (2)

Employer (2)

Approximate date of employment (2)

Approximate number of hours spent per week (2)

Specific nature of work (3)

Employer (3)

Approximate date of employment (3)

Approximate number of hours spent per week (3)

Any unusual financial circumstances that you would like the opportunity to explain; please do so on the following lines.

Please briefly describe why you believe you will be successful in your chosen profession/career, drawing upon your past experiences as well as future plans.

OPTIONAL STUDENT STATEMENT

We are interested here in anything of importance to you that will help us better understand you, your abilities, your interest, your background and your aspirations. You may use additional paper if necessary.

All scholarships are dependent upon the enrollment of the student in an undergraduate program in a community college or university.

If you are selected to receive a scholarship we will forward the amount of the tuition directly to the College or University in accordance with each institution’s billing procedures.

Application for Scholarship KIWANIS Club of Greater Brandon

BIOGRAPHIC INFORMATION KIWANIS CLUB OF GREATER BRANDON ANNUAL SCHOLARSHIP

ADDITIONAL BIOGRAPHICAL INFORMATION

EXTRACURRICULAR AND PERSONAL ACTIVITIES

WORK EXPERIENCE

OPTIONAL STUDENT STATEMENT