Kiwanis Club Of Ellicott City Application for Scholarship

Kiwanis Club Of Ellicott City

Application for Scholarship

I hereby make application for the Kiwanis Club of Ellicott City Scholarship for the college year starting in the Fall 20___. In addition to this application, please include a copy of the Student Aid Report (SAR) from your FAFSA (Free Application for Federal Student Aid).

(Please print in ink or type)
Name: _________________________________________________________________________

(Last) (First) (Middle)

Home Address: __________________________________________________________________

(Street)
__________________________________________________________________

(City & Zip) (Phone)
Social Security Number: ______ - ____ - ______ E-mail: _____________________________
Number of Years as a Resident of Howard County (minimum of 3): ___________________________________

(Please provide proof. See Instructions)

Names of Parents/Guardians: _____________________________________________________
Family information that you feel might be pertinent for committee consideration:

College(s) you plan to Attended:

Planned Major in College (if known): __________________________

Community Activities & estimate of hours
__________________________________________________________________ Year _____

__________________________________________________________________ Year _____

__________________________________________________________________ Year _____
Awards and Honors

__________________________________________________________________ Year _____

__________________________________________________________________ Year _____

__________________________________________________________________ Year _____

Financial Information
Father's (guardian's) Occupation: ___________________________________________

Place of Employment: _______________________________________________

Annual Income: ___________________________________________________

Mother's (guardian's) Occupation: ____________________________________________

Place of Employment: _______________________________________________

Annual Income: _________________________

Foster Parent stipend/support - Annual Income: _________________________
Additional factors affecting family finances: Medical, tuition, child support, and unusual situations.

Estimate of family's contribution for yearly college expenses: (dollar amount):

Estimate of student's contribution for yearly college expenses (dollar amount):

(Savings, work, etc.): __________________________________________

Estimate of other support (loan, gift, scholarships) _______________________
Estimate of College Expenses

School __________­­_________

Tuition ___________________
Room/Board ___________________
Transportation ___________________
Miscellaneous ___________________
Totals ___________________
College or Institutional Loans for which you have applied:

___________________________________________________________________________

___________________________________________________________________________

Other Loans: _________________________________________________

Submit the Essay

Submit an essay describing what you consider service in the community to be and what you could do to improve active participation in the community by local Kiwanis clubs. In addition, describe a potential service project that the Ellicott City Kiwanis Club or one of our Key Clubs might undertake to improve the community. The essay should be no less than two or more than four pages.

______________________________________________________ ____________

Applicant's Signature Date

Please return this completed application with a copy of your college transcript, the essay, and a completed copy of the FAFSA application to:
Kiwanis Club of Ellicott City

C/o Bob Martin

7130 Brangles Rd

Marriottsville, MD 21104

Email: [e-mail]
Submit these materials with a postmark no later than April 30.
NOTE: An unsigned application or missing data could be cause for an application not to be considered for this scholarship.

Rev: February 25, 2017

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