Rotary Club of Bristol Scholarship Application The Rotary Club of Bristol Scholarship Fund offers partial scholarships to students planning to attend Bucks County Community College. Eligibility Requirements: A. You are a graduating high school senior or are entering a post-secondary school for the first time. B. You are a resident of Bristol Borough or Bristol Township. C. You plan on attending Bucks County Community College. D. You are academically well-qualified to attend a post-secondary school. E. You have a record of involvement in any or all of the following: (The Scholarship Committee gives special consideration to these, especially if you have taken a role in a leadership position.) 1. School Activities 2. Community Activities/Service Religious Affiliations 3. Other Affiliations F. Financial Support is needed. Provide a copy of most recent income tax forms from your parents/guardians with social security numbers blacked out and W-2 forms attached. G. You are able to participate in a personal interview with members of the Scholarship Committee. NOTE: Children of Rotary Club of Bristol members are not eligible for this scholarship. 1
Required Documents needed to complete your scholarship application: (Only students who submit all documents will be considered. All documents must be sent to the school and forwarded to the Rotary Club of Bristol.) 1. Complete Rotary Club of Bristol Scholarship Application 2. High School Transcripts, High School Reference Forms (You need to request that these are sent by the school.) 3. Personal Reference Form Ask someone who knows you well (a teacher, employer, family friend) to complete this form and submit it. 4. Most recent Income Tax Forms and W-2s = block out Social Security numbers. Important! All required documents listed above need to be sent to the Rotary Club of Bristol and be in the hands of the Scholarship Committee by April 1, 2014. Selection Process: 1. The Scholarship Committee will review your application materials. Applicants will remain anonymous during the evaluation process. If needed, you will be contacted for a personal interview. Please remember that only students who have completely submitted all required documents will be considered. 2. Announcements of Scholarship Recipients ordinarily are made by June. 3. The Rotary Club of Bristol Scholarship Committee does not discriminate on the basis of race, color, sex, religion, national origin or physical handicaps in granting scholarships to students. Important! All required documents listed above need to be sent to the Rotary Club of Bristol and be in the hands of the Scholarship Committee by April 1, 2014. If your application materials must be sent by mail, the complete package must be postmarked no later than March 31, 2014. Mail to: Rotary Club of Bristol P.O. Box 313 Bristol, PA 19007 2
SCHOLARSHIP APPLICATION FORM Today s Date: / / NAME: Last First Middle PRESENT MAILING ADDRESS: Street City State Zip Code ( ) / / Telephone Number Birthdate Age NAME OF YOUR HIGH SCHOOL: DATE OF GRADUATION: / / LIST BROTHERS AND SISTERS (use separate sheet if necessary) NAME AGE Will this person attend college next year? NO YES NO YES NO YES 3
Using your own words, tell us about yourself: 1. ACADEMIC QUALIFICATIONS Be specific to include class rank, level of courses (AP, Honors) : 2. SCHOOL ACTIVITIES: List most recent first: (Use separate sheet of paper if necessary) Activity Leadership Role Years Involved Weekly Time Commitment 3. VOLUNTEER ACTIVITIES, COMMUNITY SERVICE, RELIGIOUS AFFILIATIONS: List most recent first (Use separate sheet of paper if necessary) Activity Leadership Position Years Involved Weekly Time Commitment _ 4
4. OTHER AFFILIATIONS, SPECIAL INTERESTS AND HOBBIES: 5. PLANNED FIELD OF STUDIES AND YOUR OBJECTIVES IN GOING ON TO HIGHER EDUCATION: (Use a separate sheet if necessary) 6. EMPLOYMENT HISTORY 5 INDICATE JOB AND EMPLOYER DATES SUMMER, PART OR FULL TIME 7. ANTICIPATED COLLEGE COSTS: A. In COLUMN 1, enter the costs you anticipate during the next academic year for each of the following items listed. B. In COLUMN 2 and COLUMN 3, enter the amount of money you expect to receive for educational expenses for the next academic year. COLUMN 1 COLUMN 2 COLUMN 3 COSTS RESOURCES LOANS Tuition Personal Services Family Room Work during school Personal
Books Parents Medical Other Relatives Travel Government Grants State (SGL) Social School Grants National Direct Student Personal Loans (NDSL) Other Other Other SUBTOTAL SUBTOTAL RESOURCES LOANS TOTAL(1): TOTAL( 2 AND 3): 8. To what other resources have you applied for financial aid? 9. In your own words, write a one page typed essay explaining how you believe this scholarship will help you. Attach your essay as a separate sheet to this application. I declare the information reported in this form is correct and complete. APPLICANTS SIGNATURE: DATE: PARENT/GUARDIAN SIGNATURE: DATE: 6
ROTARY CLUB OF BRISTOL SCHOLARSHIP HIGH SCHOOL REFERENCE AND TRANSCRIPT This form must be used Applicant s Name: Address: High School Address: SCHOOL REQUIREMENTS: (Applicant to complete the above section) 1. Copy of student transcripts 2. Total number in graduating class: 3. Student GPA: 4. Other Scholarship Awards (if known what amounts) 5. Is there a known need for financial assistance? 6. PLEASE ATTACH YOUR WRITTEN STUDENT REFERENCE TO THIS FORM Please note that it is the applicants responsibility that the High School be given sufficient time to attach the Reference and Transcript and therefore be included with the completed student Scholarship Application. All required documents and the completed application must be in the hands of the Rotary Scholarship Committee by April 1, 2014. Signed: Print: Title: 7
ROTARY CLUB OF BRISTOL SCHOLARSHIP FUND PERSONAL REFERENCE This form must be used APPLICANT S NAME: ADDRESS: HIGH SCHOOL: (Applicant completes the above section) Township or Borough State Zip Code The above named person has applied for a Rotary Club of Bristol Scholarship. These scholarships are intended for students who are academically well prepared for the program of studies they intend to follow after high school, and who also have a record of involvement in school, community and/or church activities, of leadership, and of service to others. Your comments about the applicant s qualifications against these standards are respectfully requested. Please note that it is the applicants responsibility that you be given sufficient time to write a letter of reference to be included with the completed student Scholarship Application. All required documents and the completed application must be in the hands of the Rotary Scholarship Committee by April 1, 2014. KINDLY ATTACH YOUR WRITTEN REFERENCE TO THIS FORM. Signed: Print: Title: Address: 8