Maryville Host Lions Club PO Box 211
Maryville, MO 64468
January 28, 2015 Dear Principal:
The Maryville Host Lions Club is again offering scholarships to Northwest Missouri State University for the 2015-2016 school year. Two scholarships in the amount of $1000 each will be granted to two deserving high school seniors from Nodaway County.
Enclosed is an application form. Feel free to duplicate as needed. If you have graduating seniors who are interested in applying for our scholarships, please have them complete an application and return it to you or your counselor. After completing the verification portion, send the forms to me at the address below:
Thom Alvarez
Host Lions Scholarship Committee 1503 S. Munn
Maryville, MO 64468
Applications must be received no later than Monday, February 16th in order to be considered by our selection committee. All applicants will be notified of the committee’s decisions. If you have any questions, please call me at (660) 562-3511.
Sincerely,
Thom Alvarez
Host Lions Scholarship Committee Enc
Application for Maryville Host Lions Club Scholarship
I hereby make application for a scholarship offered by the Maryville Host Lions Club. I intend to enroll in Northwest Missouri State University for the fall term of the 2015-2016 school year.
Name in full:
Last First Middle
Address: RR or Street City State Zip
Social Security #:
Phone
Birthdate
Father or male guardian’s name:
Home address: RR or Street City State Zip
Occupation and Employer:
Mother or male guardian’s name:
Home address: RR or Street City State Zip
Occupation and Employer:
1. Number of children in your family
2. Number of children in your family currently enrolled in college _
3. High School you will graduate from
4. Are you receiving any other scholarships?
If yes, please list:
a.
Amount $
b.
Amount $
c.
Amount $
d.
Amount $
5. Number of students in graduating class
Your current rank
6. Your grade point average
ACT score
7. List by name and year any honors, awards, or special recognition received during high school.
a.
b.
c.
d.
8. List by name and year leadership positions and offices held during high school.
a.
b.
c.
d.
9. List extra-curricular activities and the year in which you participated during high school.
a.
b.
c.
d.
10. What have you done or plan to do to help finance your college education?
11. Why do you want to attend Northwest Missouri State University?
12. What is your intended major? Also, describe your career goals.
13. Why are you applying for this particular scholarship?
Counselor’s or Principal’s Verification
I hereby certify that the academic information and summary of school activities as submitted on this application are correct, and that the applicant meets all requirements for this scholarship.
Signature
Title
Date