ATMORE ROTARY CLUB SCHOLARSHIPS

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ATMORE ROTARY CLUB SCHOLARSHIPS The Atmore Rotary Club is an affiliate of Rotary International, which is the world s first service club organization. More than 36 local members volunteer their time and talent to further the Rotary motto, Service Above Self. The Club supports the Academic All Stars, the 3rd Grade Dictionary Project, the Fiddlers Convention, and other community activities. Atmore Rotary Club is awarding two scholarships up to $2,000.00 per scholarship to two 2014 high school graduates with a 2.5 or higher GPA who enroll as a full-time student in a college program for the 2014 2015 academic year (fall and spring semesters). The scholarships are awarded on the basis of both merit and need. The scholarship winners will be notified in May 2014. One completed application will allow you to compete for one of the two scholarships. Your application must be complete and postmarked by Friday, April 18, 2014. Incomplete applications will not be considered. Your application packet should include the following: Application, including Statement of Finances and Essay Official High School Transcript Two (2) Teacher Recommendations (Each teacher may seal in an envelope.) Submit your application to: Atmore Rotary Club PO Box 327 Atmore, AL 36504 ****************************************************************************** Name Mailing Address City State Zip Home Address City State Zip Parent s Name Telephone Date of Birth Social Security Number High School GPA SAT Score ACT Score

List school/community extracurricular or volunteer services, activities, or organizations in which you have been active. Include dates you were involved and offices held. - List any honors and/or awards you have received. Describe your employment history. Employer Dates Type of Work Describe any obstacles that you have overcome in the pursuit of your education.

College you plan to attend What are your future educational and career goals? Describe the sources (including other grants, scholarships, and loans) and amounts of financial support available to you during the upcoming school year, together with the source and amount of other financial aid requested. Include information related to financial support from your family and income you expect to have from work. Explain how this particular scholarship will benefit you as you pursue your educational goals. Is there anything else the selection committee should know about you?

Statement of Finances The following financial information is required of all applicants and their parents. Year of most recently filed tax returns: Total number of exemptions claimed on the most recently filed US Income Tax Return. (If 2013: Form 1040, line 6d; or 1040A, line 6d; or if Form 1040EZ, indicate single or married filing jointly) Adjusted gross income (If 2013: Form 1040, line 37; or 1040A, line 21; or 1040EZ, line 4) Non-taxable income: A. Social Security Benefits B. Other (child support, welfare, etc.) Parent Student Expected gross income on return for year following the recently filed return Expected non-taxable income: A. Social Security Benefits B. Other (child support, welfare, etc.) List below any unusual expenses you and your parents may have. Do not include normal living expenses. I certify that the information submitted on the application is complete and correct. Signature Date

Personal Essay Write a personal essay on a person or event which has made a significant impact upon your ideas, personal values, future goals and educational or professional aspirations. Describe how this person or event has been influential in your life. Use only the space below.

Teacher Recommendation # 1 To Be Completed by Student Name To Be Completed by Teacher Please seal recommendation in an envelope and return to the student. Name Subject Area Total semesters the student has been enrolled in your classes Please place an X in the space that accurately describes the student. Exceptional Above Below Not Observed Organization Leadership Initiative Motivation Responsibility and Dependability Resourcefulness Creativity Capacity for Learning Quality of Work Relationship to Others Additional comments as to why student deserves scholarship: Signature Date

Teacher Recommendation # 2 To Be Completed by Student Name To Be Completed by Teacher Please seal recommendation in an envelope and return to the student. Name Subject Area Total semesters the student has been enrolled in your classes Please place an X in the space that accurately describes the student. Exceptional Above Below Not Observed Organization Leadership Initiative Motivation Responsibility and Dependability Resourcefulness Creativity Capacity for Learning Quality of Work Relationship to Others Additional comments as to why student deserves scholarship: Signature Date