Kiwanis Club of The Seacoast 2015 Scholarship Application For High School Seniors Application Post Mark Deadline: April 24, 2015 REMINDER!!! You must provide all requested documentation Incomplete applications will not be accepted General Instructions 1 Application must be filled out by the applicant Please type or print clearly 2 All requirements must be met and all information must be completed in order for the application to be considered 3 Review and complete the application checklist 4 Sign the application Return original applicationpostmarked by April 24, 2015 to: Scholarship Coordinator Kiwanis Club of The Seacoast PO Box 6576 Portsmouth NH 03802 Applicant's Details Last name First name Middle Init Number and street name City, town or suburb State Zip Telephone number Email mm/dd/yy Date of birth Secondary School Information High School Name Anticipated Graduation Date GPA weighted unweighted SAT Scores: Critical Reading Math Writing Key Club Member Yes No 1
Post Secondary Information Please list the colleges or universities where you have been accepted Mark the college or university you plan to attend with an asterisk (*) Honors and Awards Please provide information on any special honors or awards you have received in high school Extracurricular Activities Please provide information on extracurricular or outside activities (clubs, sports, etc) in which you have participated in the past four years Community Service Please provide information about any volunteer or community service work you have done in the past four years Work Experience Please provide information on any employment you have held in the past four years 2
Family Information Father s Name Occupation Employer Mother s Name Occupation Employer List names and ages of all household members (other than yourself, parents or guardians) Estimated Financial Need List the total anticipated amount you will need for the upcoming year Include the cost of tuition and expenses such as books, transportation, $ and housing List any financial aid or scholarships you will be receiving List funds you will receive from other sources, such as parental assistance, employment, savings, or gifts Calculate the amount you will need by subtracting your funding from your total amount needed Minus $ $ Please provide any additional information that you believe would be helpful to the Scholarship Committee in assessing your personal or financial need Attach a separate sheet if necessary 3
Letters of Reference Please include ONE sealed letter of academic reference from a teacher or other school official who is familiar with your academic achievements and abilities Please include TWO sealed letters of personal reference from individuals outside of school who are familiar with your personal achievements and abilities Instruct your references to sign their name across the seal of the envelope Applications without the required references will not be considered Essay Please submit a typed essay of no more than 500 words explaining your career goals and aspirations Applications without essays will not be considered Academic Transcript Please submit your high school transcript Transcript must be in a sealed envelope with the signature of a school official or guidance counselor across the seal of the envelope Checklist Please complete the following checklist to ensure that all requirements associated with your application are completed Please ensure you include all requested documentation I have enclosed the following documents: Yes No One original, completed and signed application form Letters of Reference (in sealed envelopes) Academic Transcript (in sealed envelope) Essay Scholarship Information How did you find out about this scholarship? Newspaper Web Guidance Counselor Other Applicant Certification I, the undersigned, certify that the information supplied by me in this application is complete, true and correct in every particular I agree that if I am selected to receive a scholarship award that the monies will be used for educational purposes I also agree that if selected my name and/or photograph may be used for publicity purposes by the Kiwanis Club of The Seacoast I also certify that I have read and understand the information above Applicant's signature Date 4
Additional Sheet for comments if necessary