The Florida Kiwanis Foundation 5545 Benchmark Lane Sanford, FL 32773

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1 The 5545 Benchmark Lane Sanford, FL Charles & Emilia Gugliuzza CKI Scholarship Guidelines Scholarship to be one-time award in the amount of $ scholarship available per year, as budgeted. Awarding process to be done by Scholarship Committee. Applicants Must: 1. Complete the current year official FKF application and send via US Mail to the address provided. Application must be received no later than May 30th of the current application year. 2. Have a GPA of at least 2.5 on a 4.0 scale, unweighted. 3. Be a current dues paid member of both Circle K International and the Florida District of Circle K for a minimum of 1 school year. 4. Attend an accredited College or University within the Florida District, that has an existing CKI Club. 5. Have performed at least 100 service hours within the past year(s) as a SLP / CKI member. 6. Hours must qualify as service and be verified by School or Kiwanis Advisor. (Hours relating to the building of a new CKI club are acceptable). 7. Complete essay questions per application. Grading and award of scholarships to be performed by FKF Scholarship Committee. Based on: Total number of reported Service Hours Quality of service hours Service to CKI above the club level. Answer to the questions, per essay on application Scholarships will be awarded / announced at the Florida Kiwanis District Annual Convention in August, or before. Awarded scholarship will be paid directly to the recipient in August of the qualifying year upon proof of registration as a full-time student. Applicant is eligible for only one (1) Foundation Scholarship in any given year. All scholarship winners will be required to complete a Release Form so their information may, or may not, be published by the Foundation.

2 Through the generosity of Kiwanis District Governor Charles Gugliuzza, the Florida Kiwanis Foundation is offering a $500 scholarship to an exceptional CKI Student Member. This scholarship is dedicated to his wife, Emilia Gugliuzza for her tireless efforts in helping to Eliminate Maternal and Neonatal Tetanus and her support of family, friends, and Kiwanis. Eligibility: Applicants failing to meet these requirements will not be considered for this scholarship. In the event no one meets these standards, this scholarship will not be awarded. 1. The applicant must be a dues paid member of both Circle K International and the Florida District of Circle K for a minimum of 1 school year, and currently enrolled in an accredited College or University within the Florida District. 2. The applicant must have a cumulative GPA of at least 2.5 on a 4.0 scale. 3. The applicant must have performed at least 100 hours of service in the past CKI / School year(s). Application Instructions: The application packet must be mailed to the Florida District of Kiwanis and received no later than May 30, No late submissions will be accepted. The application packet should contain the following: 1. The current / Gugliuzza CKI Scholarship form. 2. A copy of the applicant s transcripts (either official or unofficial), which includes the Applicant s name, classes, and overall GPA. 3. A detailed description of service hours in chronological order, using the format as on Appendix A. Make sure that the description of the project is detailed enough for the judges to determine if it is service. (Hours relating to the building of a new CKI club are acceptable.) 4. Essay: The Applicant must write answers to the 3 questions below, as Appendix B : (Answers must be typewritten, double spaced, 12 point Times Roman Font, and no more than 250 words per question) a) What is your definition of service and how can we instill the value of service into today's youth? b) How is Circle K unique and different from other service opportunities available? c) What are your plans for the future and how has CKI prepared you in life? 5. Recommendation Letter: Submit a letter of recommendation from either a Faculty Advisor or Kiwanis Advisor, as Appendix C. Distribution of Funds: The scholarship will be paid directly to the recipient in August of the qualifying year upon proof of registration as a full-time student. Recipient understands that the scholarship is to be used for college related expenses. The winner will be announced no later than the Florida District Kiwanis Annual Convention, or August 30, 2018, whichever is the earliest date. If the applicant wishes to have their submission back, please supply the with a self addressed stamped envelope. A copy of the winning submission will be kept by the Foundation for future reference.

3 Applicant understands that this is a one-time scholarship in the amount of ($500) five hundred dollars that is to be used for any school related expense. The number of scholarships awarded is determined annually at the sole discretion of the Board of Trustees of the Florida Kiwanis Foundation, based on the available funds. All scholarship winners will be required to complete a Release Form so their information may, or may not, be published by the. Applications missing any of the requirements above will be disqualified. The applicant should write their name on all forms and submissions. Be sure to include a summer phone number and address so we can contact you for any follow-up questions. Completed applications, with required attachments, should be mailed to: (and be received no later than May 30, 2018) The Attn: Scholarship Committee 5545 Benchmark Lane Sanford, FL Please PRINT or type LEGIBLY on the application.

4 NAME: ADDRESS: PHONE: CIRCLE K CLUB: ADDRESS: SCHOOL ID NUMBER: SCHOOL NAME, ADDRESS, AND PHONE NUMBER: GPA: NUMBER OF SERVICE HOURS: YEAR OF STUDY: Sophomore Junior Senior Graduate CLUB/DISTRICT CKI POSITION(S) HELD: I affirm that all the information I have supplied in this application is true and accurate. I understand that failure to be enrolled as a full time student at a Florida University and be a member in good standing with Circle K International and the Florida District of Circle K for the same time period will result in forfeiture of the scholarship. Applicant s Name (print): Applicant s Signature: DATE: If applicant is under 18 years of age, parent must also sign. Parent s Signature: Age: Date: SIGNATURES: I affirm to the best of my ability that the information provided by this applicant is true and accurate. Club Officer (other than applicant): DATE: Advisor (Faculty or Kiwanis): DATE:

5 Appendix A SERVICE HOURS WORKSHEET (Make additional copies as needed) DATE OF ACTIVITY ACTIVITY TITLE BRIEF DESCRIPTION OF WORK PERFORMANCE NAME OF ADVISOR TO VERIFY HOURS / PHONE OF ADVISOR ACTIVITY HOURS TOTAL HOURS Applicants Certification: These hours accurately reflect community service hours I spent during my CKI Club Year(s). : Applicant Signature Advisor Signature Date (Required)