Rotary Club of Los Angeles 2015 Scholarship Application - Due 1/20/2015 Name High School Are you the first in your family to attend college? Circle one: YES NO The Rotary Scholarship awards listed below are for $1,000 or $2,000, renewable yearly, not to exceed 4 years. Rotary Scholarship awards are available for students interested in pursuing a four-year college degree program. Minimum requirements for Rotary college scholarship applicants are: An unweighted grade point average (GPA) of 3.0 or above Completion of the (a-g courses) College Admission Requirements* (see page 6) Completion of either the SAT or the ACT College Admission Exam Extra consideration for first-generation college bound Check Box 1 or Box 2 below to indicate the scholarship for which you are applying, based on your high school s geographic location. * Box 1: Close, Coppersmith, Barr, Kirk, and Walch Family Scholarships (Downtown area schools) Student must be a senior attending one of the following LAUSD high schools or any high school or Charter High School in the downtown area: Belmont, Bernstein, Cortines, Contreras LC, Downtown Business Magnet, Bravo Med Magnet, Dorsey, Franklin, Foshay LC, Freemont, Garfield, Hollywood, Jefferson HS, Jordan, Los Angeles HS, LA Teachers Prep, LAUSD/USC Cine Arts/Engineering Mag, Lincoln, Manual Arts, Mendez, Orthopedic Hospital Magnet, RFK, Roosevelt, Roybal, Rivera, Santee, Wilson, West Adams Prep, Washington Prep * Box 2: Los Angeles Rotary Scholarship or Past President Scholarship (Greater LA area schools) Student must be a senior at a high school in LA County Check the box below only if you are planning to pursue a career in law enforcement or a related field: * Randal Simmons Scholarship Reserved for a student interested in pursuing a career in law, law enforcement or a related field. Please include the following Attachments with your application. Attachments organized in numerical order (see the list below) and with the appropriate number and your last name marked with a heavy black ink pen in lower right hand corner of each page. Please check each box after completing Section: o 1 A copy of official high school transcript (Section B) o 2 Two Letters of Recommendation by counselor and/or teacher(s) (Section B) o 3 A copy of SAT or ACT Report (Section B) o 4 Essay (See Section C) o 5 Short Answer Question (see Section D) o 6 Copies of acceptance letters to four-year colleges or universities (if available) (Section H) o 7 A copy of applicant s parents 2013 or 2014 Federal Income 1040 Tax Forms (Section I) 1 Return this page as part of your application.
INCOMPLETE APPLICATIONS OR LATE APPLICATIONS WILL NOT BE ACCEPTED APPLICATION DEADLINE: TUESDAY, JANUARY 20, 2015 Please note: All applications must be received in the Los Angeles Rotary Office by 5:00 p.m. Mail application to: Rotary Club of Los Angeles 523 W. 6 th Street, Suite 718 Los Angeles, CA 90014 Attn.: Robert Donahue, Scholarship Chair Student will complete Sections A J of this application Section A - Personal Information Name Last First Middle Permanent Address: Number and Street Apt. # City State Zip code Birthdate: / / Month Date Year Female Male Home Telephone #: Mobile Phone #: E-Mail Address: Section B - Academic Information High School: # of Years Attended This School If you have attended this high school less than 3 years, name other high schools attended: COLLEGE COUNSELOR MUST VERIFY BY SIGNATURE INFORMATION BELOW: Cumulative Grade Point Average (GPA): / (unweighted) (weighted) SAT / ACT Scores: Critical Reading Math Completion of (a-g courses) requirements (please check if completed) X *COUNSELOR SIGNATURE required to verify GPA, SAT / ACT scores, A-G Requirements Page 2 = Return this page as part of your application.
Please include the following attachments after page 2 of your application. Attachment 1 Copy of official high school transcript Attachment 2 Two Letters of Recommendation - by counselor and/or teacher(s). A third Letter of Recommendation from a Rotarian will be accepted related to your participation in Interact, RYLA, or other Rotary project. Attachment 3 A copy of SAT or ACT Report Section C Essay - Attachment 4: Topic: Describe a significant experience, achievement, challenge or risk that you have taken and its impact on you. Your essay should be no more than two pages long, double-spaced with font size 12 of Times New Roman. Section D Short Answer Question - Attachment 5: Topic: How do your own Community Service efforts relate to what Rotary does? The Objective of Rotary is to encourage and foster the ideal of service as a basis of worthy enterprise in the following ways: FIRST. The development of friendship as an opportunity for service; SECOND. High ethical standards in business and professions, the opportunity to serve society; THIRD. The application of the ideal of service in each Rotarian's personal, business, and community life; FOURTH. The advancement of international understanding, goodwill, and peace through a world fellowship of business and professional persons united in the ideal of service. Rotary was founded based on the principles of The Four-Way Test. This test asks each of us to consider the following questions: Of the things we think, say or do: Is it the TRUTH? Is it FAIR to all concerned? Will it build GOODWILL and BETTER FRIENDSHIPS? Will it be BENEFICIAL to all concerned? Please visit our website at www.rotaryclubofla.com in order to learn more about Rotary as an organization and its guiding principles. Pay special attention to the following page, which can be accessed from the link that follows or from our home page under Rotary Links Object of Rotary on the right hand side of our homepage http://www.rotary.org/en/aboutus/rotaryinternational/guidingprinciples/pages/ridefault.aspx Page 3 Return this page as part of your application.
The short answer question should be submitted as a separate attachment on a different piece of paper from your essay for Section C. Your answer for Section D should be no longer than one page and should be double spaced with font size 12 of Times New Roman. (Please note: your one-page answer must demonstrate solid knowledge of Rotary and its mission and tie it to your personal community service experience. In addition, if selected for an interview, you will be expected to touch on some or all of the following during your interview: Rotary s objectives, Rotary s avenues of service, your understanding of Rotary s Four-Way Test, etc. If selected, please be prepared to address these subjects during your interview. Sections E, F, G, H: Use an additional page(s) if needed. Section E - Community Service Experiences Describe at least three of the major community service activities in which you have participated during the past four years. Choose activities that have had the greatest impact on you or your community. Be specific about your reasons for participating in these activities and indicate your level and length of participation in each activity. Community Service Activity Reason for Participation/Impact on You Length & Level of Participation Section F - School Activities, Awards and Honors List major school activities in which you have participated during the past four years including any offices you have held. (For example: school clubs, student government, yearbook, sports, cheer, band, choir, volunteer work, etc.). *S-senior, J-junior, S-sophomore, F-freshmen School Activity, Awards and Honors *Year of Participation Offices/ Awards/ Honors Page 4 Return this page as part of your application.
Section G - Work or Intern Experiences Describe any work or intern experiences during the past four years. Employer Position Hours Per Week Rate of Pay Hr/Wk/Mo $ $ $ Length of Employment From To Section H - College Information Please list all colleges to which you have applied and requested financial aid. List colleges in order of preference. Name of College or University Acceptance Letter Received? Attachment 6 Copies of acceptance letters to four-year colleges and universities that you have received, if available. Section I - Family Information Father's Name: Mother's Name: Number of children in your family Occupation: Occupation: Number of brothers and/or sisters in college in the upcoming academic year: (Do not include yourself). Parents combined annual income last year (2014): $ Has any member of your immediate family attended a college or university? yes no Has any member of your immediate family received a college degree? yes no Page 5 Return this page as part of your application.
Attachment 7: A copy of applicant s parents 2013 or 2014 Federal Income 1040 Tax Form. Note: If your parents did not file a Federal Income Tax Return in either 2013 or 2014, please submit a letter, signed by the parent, explaining why returns were not filed. This letter should also include the amount of your parents 2013 or 2014 combined income. All financial information submitted is kept confidential. Section J - Certification I hereby certify that the information provided on this form is complete and accurate to the best of my knowledge. For Student Signature Date For Parent or Guardian Print your name Signature Date Scholarship Application Due in Rotary Office on or before 5 PM January 20, 2015 Mail completed application to: Rotary Club of Los Angeles 523 W. 6 th Street, Suite 718 Los Angeles, CA 90014 Attention: Robert Donahue, Scholarship Chair A digital copy of this scholarship application is available at http://www.rotaryclubofla.com. See the Scholarship drop down menu. Questions? Email dr.robertdonahue@gmail.com *(a-g courses) Requirements: Complete a minimum of 15 college-preparatory courses (a-g courses), with at least 11 finished prior to the beginning of your senior year. The 15 courses are: a. History/social science 2 years b. English 4 years c. Mathematics 3 years d. Laboratory science 2 years e. Language other than English 2 years* f. Visual and performing arts 1 year g. College-preparatory elective 1 year (chosen from the subjects listed above or another course approved 1 year by the university) *or equivalent to the 2 nd level of high school instruction Earn a grade point average (GPA) of 3.0 or better with no grade lower than a C. Page 6 Return this page as part of your application.