GURNEE ROTARY CLUB VOCATIONAL SCHOLARSHIP APPLICATION Scholarship grants will be awarded to support educational programs preparing students for vocational or technical careers attainable with less than a four-year degree. Grants will be limited to an Associate Degree or equivalent certification program. The Deadline is Jan. 31, 2008. To be submitted: · One completed and legible application form suitable for photo-copy reproduction and distribution to Rotary Vocational Scholarship Committee Members · Two letters of reference must accompany this application · Transcript of high school and/or community college (if applicable) grades ****************************************************************************** Name ________________________________________________________________________ Last First Middle Initial Address ______________________________________________________________________ Street City State Zip Code Date of Birth _____/_____/________ Social Security Number ________-______-__________ E-mail ___________________________________ Phone (______) ______________________ Parent/Guardian ______________________________________________________________ Address ______________________________________________________________________ Street City State Zip Code E-mail ___________________________________ Phone (______) ______________________ Intended School or Community College Name _____________________________________________________________________ Street Address _____________________________________________________________ City, State, Zip Code ________________________________________________________ Financial Aid Coordinator ___________________________________________________ E- mail __________________________________ Phone (______) ____________________ Describe Intended Vocational or Technical Program ________________________________ ______________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________ Describe all completed coursework, volunteer experience, hobbies, competitions or awards in your Chosen Field. ___________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ HIGH SCHOOL RECORD Name and Address of School Attended _________________________________________________ _________________________________________________ _________________________________________________ Number in Class ___________ Rank in Class _______________ Graduation Date _______________ Responsibilities at School (Clubs, Offices, Sports, Etc.): _____________________________________ __________________________________________________________________________________________________________________________________________________________________________ Other Activities in the Community and/or Workplace: ______________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ Counselor's Recommendation/Comments (Optional): _______________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ What Are Your Future Plans? __________________________________________________________ ________________________________________________________________________________________________________________________________________________________ Applicant's Acknowledgment: I have completed this single copy application and have provided the required supporting documents. I understand that I must stand ready to be interviewed. _______________________________________ ____________________ Applicant's Signature Date SPONSORING ROTARY CLUB ENDORSEMENT Date _______________________ The Rotary Club of __________________________________ has evaluated and hereby submits this application of ___________________________________ to the District 6440 Vocational Scholarship Program Committee for its further consideration. This application has been carefully reviewed and the Club's Board of Directors gives this applicant its unqualified endorsement. Club President Signature _______________________________ E-mail _________________________ Printed Name ______________________________ Daytime Phone (______) ____________________ Vocational Chair Signature ______________________________ E-mail ________________________ Printed Name ______________________________ Daytime Phone (______) ____________________