CALDWELL ROTARY CLUB ACADEMIC SCHOLARSHIP APPLICATION AWARD AMOUNT: $1,000.00

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1 CALDWELL ROTARY CLUB ACADEMIC SCHOLARSHIP APPLICATION AWARD AMOUNT: $1, (two will be awarded) To Qualify For This Award, you must: APPLICATION DEADLINE IS APRIL 15 (of the year you graduate from High School) 1. Be a resident of Idaho 2. Be a graduating senior of a Canyon/Owyhee County high school 3. Have a cumulative GPA of 2.8 or higher (4.0 system) 4. Take the ACT or SAT 5. Have demonstrated commitment to public service 6. Enroll as a full-time student in an eligible post-secondary educational institution in Idaho. 7. Attend the first semester of college following high school graduation. Instructions: Complete the application; either typed or legibly print all requested information Copy of transcript of your grades from grade 9 through grade 12 that are currently on file at your school. Sign statement that you will comply with terms of the award. Two letters of recommendation are required from people who are not related to you, that know your interests, achievements, and potential for success at the college level. Attach an essay of not more than 500 words sharing information about; yourself, your academic interests, and your plans for the future. SEND APPLICATION TO: Caldwell Rotary Club/Scholarships PO Box 24 Caldwell, Idaho If you have questions about this application, see your high school counselor Or contact Leora Summers at To Be Considered Applications must be postmarked no later than April 15th of year you graduate.

2 Page 1 SECTION I 1. Name 2. Permanent Address/Phone Number/ Address Street Address City, State, Zip Telephone Number(s) address: 3. Parent(s) or legal guardian (with whom you reside) Father s Name Mother s Name Guardian s name if other than parent Guardian s relationship 4. Name of High School County Month and Year of Graduation Principal s Name School Phone Number 5. Academic Area of Interest

3 SECTION II Page 2 APPLICANT S NAME I am a resident of Idaho I hereby affirm that: I will enroll as a full time student (min 12 semester credit hrs.) in an undergraduate academic program in an eligible Idaho college or university pursuit of a first degree or certificate that requires at least six consecutive months of attendance. I will use the funds of the scholarship for educational costs only. I will comply with all provisions of the Caldwell Rotary Club Scholarship and the rules and regulations of the educational institution that I attend. All of the information that I have submitted in this application is true and correct. Signature of applicant date IMPORTANT NOTE: Late applications will not be accepted. Incomplete applications will not be considered. Please double check all your information for neatness and that it is complete.

4 Page 3 APPLICANT S NAME LEADERSHIP AND ORGANIZATION PARTICIPATION Please list leadership positions and organizations you belong/belonged to during high school.

5 Please make more copies of this page if needed! APPLICANT S NAME VOLUNTEER AND SERVICE PROJECTS Page 4 Please provide information about volunteer, service projects, and activities during your high school years only. School years you were involved in this project School years you were involved in this project School years you were involved in this project School years you were involved in this project Please make more copies of this page if needed!

6 APPLICANT S NAME: VOLUNTEER/PUBLIC SERVICE ACTIVITY REFERNCES Page 5 REFERENCE #1 NAME: ADDRESS: PHONE NUMBER(S): ADDRESS: RELATIONSHIP TO APPLICANT: REFERENCE #2 NAME: ADDRESS: PHONE NUMBER(S): ADDRESS: RELATIONSHIP TO APPLICANT: REFERENCE #3 NAME: ADDRESS: PHONE NUMBER(S): ADDRESS: RELATIONSHIP TO APPLICANT: Use additional paper as needed to support references for public service/volunteer work that you have done while in high school.

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