Rotary Club of Peoria Scholarship Application

THE BLUMENTHAL SCHOLARSHIP

OF THE ROTARY CLUB OF PEORIA SCHOLARSHIP APPLICATION

2011/12 ACADEMIC YEAR

Albert Blumenthal and his family are holocaust survivors who came to Peoria after World War II. Albert attended Peoria High School graduating in 1951 and received a scholarship from The Rotary Club of Peoria. Without financial assistance he would not have been able to enter college and go on to be a successful businessman. Mr. Blumenthal wants to repay what he considers a longstanding debt by helping students who might not otherwise have the financial resources to further their education beyond high school. Mr. Blumenthal and his wife are the primary benefactors of this scholarship in cooperation with The Rotary Club of Peoria.

Mr. Blumenthal’s sister is Marion Blumenthal Lazan, author of the book “Four Perfect Pebbles” which is the story of the family’s Holocaust survival. Copies are available in the Peoria High School Library.

APPLICANT/SCHOLARSHIP CRITERIA:

1.  Applicant must be a graduate of Peoria High School.

2.  Financial need as demonstrated by FAFSA (filed by March 1) will be the primary criterion for the award; high school grades are the secondary criterion.

3.  Financial Assistance will be paid for full time students at any accredited University, College or Community College. All payments will be made directly to the school, on the recipient’s behalf, to be applied in the following sequence:

(1) tuition, (2) books & fees, and (3) the balance, if any, for room & board.

4.  Applicant should, in the opinion of teachers and counselors, have demonstrated intellectual growth during progression through high school. Recommendation forms are provided as part of the application form.

5.  Applicant should describe in brief narrative form, not to exceed one page, her or his career goals and aspirations and the plan to achieve them.

6.  Award is available for up to $5000 for the first academic year beyond high school.

7.  Award to be made by the The Rotary Club of Peoria.

8.  Lineal descendants (child or grandchild by blood or legal adoption), step children or spouses of Rotarians are not eligible.

SUBMIT COMPLETED APPLICATION TO:

Carol Spayer

Counseling Office

Peoria High School

The deadline for applications is Thursday, March 18, 2010.

APPLICANT’S NAME ______AGE ___ SOC. SEC. # ______

HOME ADDRESS ______

Street City State Zip

Home telephone ______

HIGH SCHOOL GPA (based on 7 semesters) ______HIGH SCHOOL RANK ______OUT OF ______

ACT SCORE ______SAT SCORE (if applicable) ______

EXTRACURRICULAR ACTIVITIES including employment: (Use additional sheet if necessary) ______

ACADEMIC HONORS ______

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PARENT/GUARDIAN INFORMATION

NAME(S) ______

Father Mother

OCCUPATION(S) ______

EMPLOYER(S) ______

How many siblings in your family are still dependent on your parents for financial support? ______

List the name of the accredited University, College or Community College you plan to attend.

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Have you been accepted to the above school? ______

Have you received any other scholarship money for the 2011/12 academic year? ____ Yes ____ No

If yes, please list those scholarship awards including the amount of each.

Attach a ONE page essay of your career goals and aspirations and your plan to achieve them.

Attach completed recommendation form from a teacher, counselor or administrator at Peoria High School.

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Applicant’s Signature Date

Scholarship awards are given for one academic year.

RECOMMENDATION FORM

To be completed by a teacher, counselor or administrator at Peoria High. (Duplicate if necessary.)

NAME OF SCHOLARSHIP APPLICANT ______

TEACHER/COUNSELOR/ADMINISTRATOR NAME ______

Has this student demonstrated intellectual growth during high school? ______Please include supporting comments:

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