Application for Rotary Club Scholarship!
 
 
 
The Pittsburgh Rotary Club Foundation
Scholarship Program
 
APPLICATION FORM
(This application may duplicated for multiple students)
 Full Name:                                                                                                                                                                   
 Mailing Address:                                                                                                                                                        
                                                                                                                                                                                   
 Telephone Number:                                                    Last 4 digits of Social Security Number:                                 
 High School Academic Curriculum:                                                                                                                          
 GPA:                                                                 SAT or ACT Score:                                                                           
Special Awards, Achievement, Extra Curricular Activities:                                                                                        
 
                                                                                                                                                                                   
                                                                                                                                                                                   
 Planned field of study:                                                              Degree sought:                                                         
 Total gross taxable current custodial family yearly income:                                                              Family Size:                
 Is there any non-taxable income, if so from what source. (401K, Mutual Bonds, Mutual Funds in IRA, etc. ) ___________
__________________________________________________________________________________________________
 Will you be receiving any other Grant or Scholarship money?                                                                                              
 If so, from what source and how much?  $                                                                                                               
Where did you learn of this scholarship? _________________________________________________________________
 You may be asked to verify income through a Free Application for Federal Student Aid ( FAFSA) form from either immediate year or previous year;  if there are any special circumstances about your financial situation, please describe them on a separate sheet.
 
I hereby certify that the foregoing statements are true and correct to the best of my knowledge and belief, and hereby grant the Pittsburgh Rotary Foundation scholarship committee permission to verify such statements and investigate all information submitted as part of this application (i.e. transcripts, references, family income.)  I understand that any false statements on this application may be considered sufficient cause for rejection of this application or for revocation of a scholarship award if such false information is discovered subsequent to receiving the award.
 
 
 Signature                                                                                                           Date:                                                             
                                                            (Student)
 Signature                                                                                                           Date:                                                             
                                                            Parent/Guardian)
 
 
 
 
 
The Pittsburgh Rotary Club Foundation
Scholarship Program
 
 
 
     Welcome to the Pittsburgh Rotary Club Foundation Scholarship Program for high school seniors in Allegheny County.  This program will award six $1,500 one-time scholarships to those candidates chosen by our Foundation Scholarship Committee.  Below you will find a list of requirements and rules.  Failure to adhere to our rules or furnish the required application components will disqualify the submitted application.
 
          Criteria for Eligibility:
  • Applicant must have a 3.2 GPA or higher.
  • Applicant must be a high school senior who is applying to colleges.
  • Applicants must be currently attending high school in Allegheny County.
 
Application Components:
  • Completed application form.  All questions must be answered. 
  • Please provide full address including zip code.
  • Must include total gross custodial family yearly income.
  • Must include other grant information.
  • Must include total family size.
 
  • Two letters of recommendation:  One from a teacher or school administrator; and one from a community leader, work supervisor, minister, etc. Each letter must be in a sealed envelope with signature of recommender across the seal.
 
  • A 400-600 word typewritten essay describing how higher education will help you, the applicant, to achieve your life goals.
 
  • A separate document outlining your community service projects.  Do not substitute a resume for this section. Describe your involvement, how many hours, what you have learned from the experience, etc.
 
  • Official high school transcript covering your freshman year up through your most recent senior semester.
 
  • Deadline for turning in complete application package is Friday, March 11, 2016. Materials received after this date and time will not be considered. Application must be received in the Rotary office by 4:00 pm.  You may mail the packet to:
 
          Pittsburgh Rotary Club
          555 Grant Street, Suite 328
          Pittsburgh, PA  15219
 
Questions can be directed to the Rotary Office at 412-471-6210 or office@pittsburghrotary.org
 
 
APPLICATIONS RECEIVED AFTER MARCH 10th, 2017 WILL NOT BE ACCEPTED.