Brisbane Lions Club
Brisbane Lions Club
Scholastic Achievement Awards Application
Candidate Name: ______Date: ______
Criteria: Scholastic Achievement Record Grant/Awards: Range from $500 to $2,500
Desires and Goals (subject to change without notice)
Financial Need
Applicants must be current Brisbane residents for one year or longer - exceptions: living away at
schoolwith parent(s) or guardian living in Brisbane, or serving as a member of the U.S. military. Please confirmyoureligibility status by contacting the committee prior to submitting your application.
Application Procedure:
1. Deliver completed application including: Official Grades Transcript, and Reference Letters.
by April 11th to: Brisbane Lions Club
Scholastic Achievement Awards
P. O. Box 317
Brisbane, CA 94005 or all may be submitted via Email at:
Late submissions may be returned!
2. Answer questions by phone if requested, and if selected as a finalist: attend an interview, which
in case of students away at school may be conducted via conference call.
The Brisbane Lions Club serves our community in many ways. One of the most important is the support of education. Through the efforts of our members and the support of our community, we offer awards to those who are pursuing higher education. Last year we were able to direct $25,000 total to 23 deserving students. Please follow these guidelines to participate in this year’s awards.
Publication Release: Applicant, or parents if you are under age 18 authorize the
Brisbane Lions Club and its affiliates to use a full, partial, or
edited version of your essay responses, or photos which are taken,
in public at the award presentation.
You waive all rights to any compensation, or claims of any damages.
Award Presentation Dinner: May 27, 2014 7:30pm
All applicants selected are invited to be the guests of the Brisbane Lions Club for a Presentation of Awardsat the Brisbane Community Center. Applicants are guests of theBrisbane Lions Club. Awardswill be presented to all recipientsselected who are able to attend, or to a member of their family if the recipient is unavailable, and if no one is present to receive the Award, it will be mailed to you.
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Brisbane Lions Club
Scholastic Achievement Awards Application
GENERAL INFORMATION:
ApplicantName: ______
Address : ______
Phone : ______
Email : ______
School you currently attend: ______
Schools you have applied to for admission: ______
(if not already accepted or attending)
______
______
DESIRES & GOALS: ______
(attach additional pages if needed) ______
______
Major if declared: ______
Employment Experience: ______
(attach additional pages if needed)
______
Attach CV if you prefer: Yes [ ] No [ ]
Family information: ______
______
______
______
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Brisbane Lions Club
Scholastic Achievement Awards Application
Transcripts: Attached [ ] or To be forwarded by school [ ]
NOTE: 2-3 years transcripts are requested. If multiple schools, please include all.
College/University GPA: ______
High School GPA: ______
Test Scores: SAT: ______
If Available SAT II ______
ACT: ______
Graduate of:
High School: Year: ______
College/U: Year: ______
Trade if applicable: ______Year: ______
Degrees earned: ______Year: ______
______Year: ______
Honors received: ______Year: ______
Activities/Interests/Community Service:
Please give us a good understanding of who you in general beyond your scholastic achievements.
Attach your answers to this application, or as an
email attachment: ).
A. What event has most inspired you?
B. What do you plan to do with your life?
C. Why is it important for you to pursue your educational goals?
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Scholastic Achievement Awards Application
FINANCIAL NEED:
EXPENSES: Please showyour anticipated expenses for the current year (next 12 months).
Tuition and fees
Room and board
Books and supplies
Other School fees (?)
Transportation
Any other (?)
Total Estimated Expenses: ..$______
INCOME: Please show what sources of income you anticipate for the current year (12 mos.)
including any grants or scholarships other than what may be awarded to you
by the Brisbane Lions Club.
Your primary source of funds are from: your job [ ], parents/savings [ ], or loans [ ]?
Parents
Personal savings
Current job/business
Grants
Scholarships
Loans
Total Estimated Income: ...$______
Are you the primary caretaker for a parent, child or other relatives? Yes [ ] No [ ]
If applicable: how does that responsibility impact your ability to attend school?
______
Reference Letters:
Please provide three (3)verifiable written recommendations. These may be hand written or email.
Reference sources: Teacher, Professor, Clergy, or other Mentor.
1. Name: ______Tel.: ______Occ.: ______
2. Name: ______Tel.: ______Occ.: ______
3. Name: ______Tel.: ______Occ.: ______
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