Freeport Lions Club: January 2013

Copy this text and print out your application for here.

(or Contact Terry Anderson at the email address shown below)

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$1000.00 SCHOLARSHIP GRANT PROGRAM

2013 – 2014 - BASIC REQUIREMENTS FOR ELIGIBILITY

HUMANITARIANISM - This award shall be made to the student who practices, through their expressed thoughts and actions in their daily life, concern for the welfare of the human race, regardless of creed, race, sex or ethnic background.

LEADERSHIP - Shown an interest in college by participating in extra-curricular activities.

DEDICATION - Active dedication to promotion and growth of high school/church/community.

A. Student must currently be a Senior in Freeport High School or Aquin High School and after seven semesters of high school must have a minimum “C” or better Grade Point Average. This Scholarship Grant will be given to help underwrite the costs of full-time courses of study after high school.

B. No later than the 1st semester of the year following high school graduation, the student must enroll at Highland Community College.

1. The course of studies selected must have the student carrying no less than ten (10) semester credit hours. Student must maintain a “C” or better GPA at the end of each semester to qualify for full scholarship payment.

2. “GPA Pay Out Table”shows pay outs based on GPA average:

2.5 and Above = $1000.00	2.0 - 2.24 = $400.00
2.25 - 2.49 = $700.00	Less than 2.00 = $0 Paid

C. The “APPLICATION FORM” and a “TRANSCRIPT OF HIGH SCHOOL GRADES” must be returned to Freeport Lions Club at the address or email below postmarked or emailed no later than April 12, 2013. Late applications will not be considered.

FREEPORT LIONS CLUB

% Terry Anderson - Scholarship Committee

2328 Swan Drive

Freeport, Il 61032

or email to:

andersontg@aol.com or serafini77@comcast.net

D. Freeport Lions Scholarship committee shall select the recipient of this award and will present the scholarship certificate during awards ceremony at their school.

E. Payment of this Scholarship will be made in one-half increments. Student will be paid first installment up to $500.00 upon submitting verification to the Freeport Lions Club on completion of his/her first freshman semester. Student will present copy of their transcript for that semester’s earned credit hour grade report (GPA). Student will receive final installment up to $500.00 upon submitting a copy of their transcript of the second freshman semester’s earned credit hour grade report (GPA).

F. The Scholarship Grant will be canceled if the Applicant is arrested or charged with the use of drugs or alcohol at any time during the year.

G. If the student withdraws or transfers from Highland, any Scholarship payment made is expected to be repaid to the Freeport Lions Scholarship Fund.

All questions on the APPLICATION must be answered completely and truthfully. If answers are found to be not true, the Scholarship Grant will be void. If more room is needed to answer any questions, use another sheet and attach to Application Form.

“WE SERVE”

2012 – 2013 - $1000.00 SCHOLARSHIP GRANT APPLICATION FORM

“2013 GRADUATING SENIORS FROM FREEPORT HIGH SCHOOL OR AQUIN HIGH SCHOOLS”

1. Name: __________________________ Birth Date: _____________ Phone:

2. Address:

Street / PO Box City State Zip

3. Father: Mother:

Address:

Occupation:

Employer:

Family Income (combined in 2012): $

Custodial Parent (s):

4. Number of Children in Family (Including Self): _____________ (List name(s) & ages)

5. Brothers / Sisters currently attending college or vocational / technical school: (List sibling names, ages, & name of school)

6. List Extra-Curricular high school, community, and church activities.

7. High School: _________________________ Rank in Class: ______Out of _______ Students.

ACT score (highest): ___________

8. List any Family Member(s) or Relative(s) who are in a Lions Club or who volunteered to help for Lions/Lioness Club Activities:

____________________________________________________________________________

9. Attach letter of recommendation from a non-relative such as a teacher, minister, priest, or employer.

10. Type or print in 200 words or less (on reverse side or attach separate sheet):

A. Why did you apply for this scholarship/grant award?

B. List characteristic(s) about yourself that distinguish you for this award selection?

C. How do you feel your chosen field of study could make a difference to serve others?

I have read “Basic Requirements for Eligibility” information sheet; I meet those requirements; and I have answered all questions completely on the “APPLICATION FORM”. All the information submitted is correct.

Applicant Signature: ________________________________________ Date: _______________

Parent Signature: ___________________________________________ Date: _______________

Question #10 (200 words or less):

_________________________________________________________________________________

Membership Info - Contact Joe Sarafini (815) 275-8737 or Terry Anderson (815) 566-7977

Tuesday, January 8, 2013

2013-2014 Scholarship Application Form

$1000.00 SCHOLARSHIP GRANT PROGRAM