KIWANIS CLUB OF APPLETON, WI GOLDEN K SCHOLARSHIP Scholarship Award: $1,000 non-renewable scholarship to one student from each of the five Appleton High Schools Three high school seniors, who reside in the Appleton Area School District, will be selected for an interview for this scholarship from each the following high schools: Appleton East, Appleton North, Appleton West, Xavier, and Fox Valley Lutheran. Scholarship candidates will be evaluated on the following basis: Minimum cumulative 3.0 GPA Residency in the Appleton Area School District Plan to pursue a post-secondary degree at an accredited college or university (two or four year) or a technical college Participation in school activities Participation in community activities Work experience Students applications are due in their Guidance Office by February 15. Guidance Office Please review applications and select 3 applications to be forwarded to the Community Foundation Office by March 1. These 3 students will be interviewed at your school on the following dates by Kiwanis Club Representatives. Please schedule ½ hour for each student on the appropriate date and time. Appleton East Monday, April 24, 2017 9:00 a.m. Appleton West Monday, April 24, 2017 11:00 a.m. Appleton North Tuesday, April 25, 2017 11:00 a.m. Fox Valley Lutheran - Tuesday, April 25, 2017 1:00 p.m. Xavier Wednesday, April 26, 2017 1:00 p.m. Forward applications via email, mail or fax to: Community Foundation for the Fox Valley Region 4455 W. Lawrence Street Appleton, WI 54914 Fax: 920-830-1293 scholarships@cffoxvalley.org The application packets must include: Complete application Grade transcript ACT/SAT scores Student essay Two Letter of recommendation Notification: All applicants that are interviewed will be notified of the committee s decision by mail. Questions: Scholarship questions should be directed to the Community Foundation for the Fox Valley Region at (920)702-7619, or scholarships@cffoxvalley.org.
KIWANIS CLUB OF APPLETON, WI GOLDEN K SCHOLARSHIP APPLICANT INFORMATION Name: Sex: M F (circle) Address: City: Home Phone: State: Zip: Cell Phone: Email: Date of Birth: EDUCATION Name of school currently attending: GPA: Graduation Date: Date and time of High School Awards Ceremony: Education Institution you plan to attend in fall: First Choice: Second Choice: Have you been accepted at your first choice? Yes No If no, when do you expect to be notified: Have you been accepted at your second choice? Yes No If no, when do you expect to be notified: Intended Major: ESSAY QUESTION (Attach separate sheet if necessary) Please respond to the following question in 100 words or less: Why is furthering your education important to you?
EMPLOYMENT (Attach additional sheet if necessary) List jobs and type of work you have held. Name of Employer Dates of Employment Type of Work Hours worked per week COMMUNITY SERVICE (Attach additional sheet if necessary) List volunteer work or community service you performed without pay starting with the most recent. Please list approximate total hours of work/service, not average hours per week. Name of Organization Dates of Participation Type of Work/Service Total Hours of Work/Service
EXTRACURRICULAR ACTIVITIES INVOLVEMENT (Attach additional sheet if necessary) List your extracurricular activities involvement, starting with the most recent. Attach extra pages if necessary. Activity Dates of Participation Specify Leadership Position Held OTHER SCHOLARSHIPS List all scholarship for which you have applied Name of Scholarship Annual Amount (indicate over how many years) Status: unknown, approved, pending
Application Certification: I hereby certify that the information given in this application is accurate and complete to the best of my knowledge. I understand that misrepresentation in any statement may be considered reason for disqualification and/or repayment of any scholarship. If I am awarded a scholarship, I agree to abide by all requirements and responsibilities of the award. I understand that should I be named as a scholar, any non-financial information in the application could become available to the public. I further understand that according to federal tax laws, the scholarship(s) will be taxed as ordinary income if used for purposes other than qualified education expenses. (Information can be found at www.irs.gov/uac/tax-benefits-for-education:-information-center.) Applicant s Signature: Date: / / Printed Applicant Name: All student applications must be received in their Guidance Office by February 15 High School Counselors Please forward the applications of the 3 students to be interviewed by March 1 to: Community Foundation for the Fox Valley Region 4455 W. Lawrence St. Appleton, WI 54914 Fax: 920-830-1293 Email: scholarships@cffoxvalley.org The application packet must include: Complete application Grade transcript ACT/SAT scores Student essay Two Letters of recommendation