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Seguin Sunrise Lions Club
Seguin HS – Navarro HS of 2015
SCHOLARSHIP APPLICATION PACKET
The Seguin Sunrise Lions Club will be awarding six (6) scholarships to members of
your class.
We will consider awarding scholarships on the basis of merit,
citizenship, and need. We will award scholarships for vocational, technical, Junior
College, and 4-year institutions.
Below is a checklist of the items to complete and return to your counselor’s
secretary. The application deadline is noon on April 3rd, 2015.
Your counselor MUST write a recommendation. Our Club is planning a Scholarships
Recognition Dinner in honor of our recipients as well as their parents/guardians.
Congratulations as you approach your graduation and best wishes to each of you
from the Seguin Sunrise Lions Club.
1. ______________ Complete the attached application.
2. ______________ Attach a personal statement to include your goals, future
plans, as well as how this scholarship would help you.
3. ______________ Attach your high school transcript to your application.
4. ______________ Return the completed application to your counselors
secretary prior to April 3rd, 2015.
5. Ask your counselor to complete a recommendation statement.
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Seguin Sunrise Lions Club Scholarship
Name: __________________________ _________________ ____________ DOB: _________
Last
First
Middle
Address: ______________________________________________________________________
Phone: ________________________________ Social Security No.:______________________
Live with (check which applies):
Both Parents____
Mother____
Father____
Guardian____
Other______
Father’s Name: ________________________ Address: _________________________________
Mother’s Name: _______________________ Address: _________________________________
TOTAL Combined Annual Income:
______$115,000- or more
______$85,000-114,000
______$84,999 - 55,000
______$54,999 - 25,000
______$24,999 or less
Number of Minor Siblings and their Ages: _____; ________________________________
Family Members currently attending College; Class & Name of College:
_______________________________________________________________________
Where do YOU plan to attend College or Trade School? ________________________________
1st Choice: _____________________________ 2nd Choice: ____________________________
Have You Applied for College? ______ Have YOU been accepted to a college? _____________
College Major: ___________________ Future Occupation Goal: ________________________
Where do YOU plan to live while attending College? _____ On Campus, _____ Home,
______Apartment or ________ Fraternity or Sorority House
Have you already received a Scholarship? _______ If so, what amount: _________________?
Other Grants or Monetary Support and Amounts: ______________________________________
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Have you applied for Financial Aid? ____ If so, which schools? __________________________
Do you plan on working while attending college? ______________________
Past Employment: ______________________________ From: __________ To: ___________
Employer
Month/Yr
Month/Yr
________________________________ From: __________ To: ___________
Employer
Month/Yr
Month/Yr
List High School Activities and/or Awards
9thGrade:______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
10thGrade:_____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
11thGrade:_____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
12thGrade:_____________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Activities Outside of School (Civic, Community, Church, Volunteer,
etc….):_______________________________________________________________________
______________________________________________________________________________
_________________________________________________________________________
In order to comply with the Federal Privacy Rights to Parents and Students Act, a school must
obtain signed authorization before it can release student information for scholarship
consideration. Permission is hereby given to school officials to release the secondary school
record and other requested information for consideration of Class of 2015 Scholarship.
____________________________________________________ ________________________
Student’s Signature
Date
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