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Scholarship Application
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Rotary Club of New Bedford

Founded in 1921

 

Scholarship Application

 

Open to residents of New Bedford and/or graduates of a New Bedford high school

 

Award amount:  $1,000

 

Deadline: Wednesday, May 31, 2017

 

Please complete this application form in full.  Incomplete applications will not be considered.

 

Name_________________________________________________________________________________ 

 

Telephone# ____________________________________________________________________________

 

Address _______________________________________________________________________________

 

Town/City & Zip________________________________________________________________________

 

Date of birth: ________________    e-mail address _____________________________________________

 

High school you attend:  __________________________________________________________________

 

Last 4 digits of Social Security #: ____________

 

Total number in class: _____________ class rank: ____________________ GPA: ____________________

 

 

College/university you will attend in 2017-2018:

 

______________________________________________________________________________________

(please enclose copy of college acceptance letter)

 

Estimated expenses:

 

Tuition: $__________________ room & board: $_________________ other: $______________________

 

Are you planning to live on-campus (yes/no/undecided)? ________________________________________

 

 

Describe community service activities that you do/have done:

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

 

List awards/recognitions you have received:

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

 

List any extra-curricular activities, sports, or other organizations/activities in which you participate:

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

______________________________________________________________________________________

 

 

Do you work? _______________  

 

If so, where? ___________________________________________________ hours per week? __________

 

 Have you received other scholarships/grants? _________

 

If so, in what dollar amounts? $_____________________________________________________________

 

 

Mother’s name: _________________________________________________________________________

 

Mother’s place of employment: ____________________________________________________________

 

Mother’s annual salary: $______________________

 

Father’s name: _________________________________________________________________________

 

Father’s place of employment: _____________________________________________________________

 

Father’s annual salary: $_______________________

 

 

Number of siblings: _______ ages: _________________________________________________________

 

Siblings enrolled in college? ____________

 

Annual college expenses (siblings): $________________________________________________________

 

 


The following materials must be submitted along with the completed application.

 

An official high-school transcript

 

A letter of acceptance from the college or university (or copy thereof)

 

An original essay (approximately 250-300 words, typed and double-spaced); the subject of the essay is left to your discretion

 

At least two letters of recommendation (from teachers, guidance counselors, etc.)

 

 Mail to:     Rotary Club of New Bedford

                    Rich Medicke, Vocational Committee Chair  
                    P.O. Box 7743

                    New Bedford, MA  02740-7743

                      

 

If you have questions or need assistance, please contact Rich Medicke at 508-965-0873 or at rich.medicke@verizon.net.

  

 

The Rotary Club is the world’s largest volunteer service organization.  Rotary members are business and professional leaders who work in their communities to help promote world understanding and peace.  Rotary’s 33,000 clubs in more than 200 countries and regions encourage high ethical standards and carry out humanitarian projects to address such issues as poverty, health, hunger, education, and the environment.