WICHITA FALLS FOUNDER LIONS CLUB SCHOLARSHIP
(Revised March 2016)
AWARD:
Scholarship(s) for $500 per semester renewable for up to 4 years (8 semesters) will be awarded in summer of current year.
ELIGIBILITY:
v Graduate of a Wichita Falls or immediate local area ISD high school (Burkburnett, Holliday, Henrietta, Iowa Park, Windthorst, etc.) or member of MSU Lions Club
And
v Current or future enrollment at any college, university, or technical school only within the state of Texas
v Minimum academic GPA of 2.5
v Financial need will be a primary consideration
APPLICATION DEADLINE: June 5 of current year
SCHOLARSHIP INTERVIEWS: The scholarship committee will review applications and select candidates for interviews that will be held during the month of June of current year.
In person interviews will not be rescheduled due to scholarship applicant conflict. No phones interviews will be conducted.
WITH COMPLETED APPLICATION, PLEASE SUBMIT THE FOLLOWING:
1. Current transcript
2. One letter of recommendation—may be from employers, teachers, clergy, community leaders or longtime friends.
For more information, please contact:
Randy Cooper, Scholarship Chair, at 940-322-2012 or or Chrissie Richardson at 940.322.2012,
Wichita Falls Founders Lions Club
Information provided is used solely in determining the applicant’s eligibility for scholarship aid funds in accordance with the guidelines established by the Wichita Falls Founder Lions Club.
DATE: ______
NAME: ______
Last First Middle
AGE: ______DATE OF BIRTH: ______
PERMANENT ADDRESS: ______
Street City State Zip
PERMANENT HOME E-MAIL ADDRESS: ______
PERMANENT HOME TELEPHONE # ______CELL # ______
CURRENT SCHOOL ADDRESS: ______
Street City State Zip
CURRENT PERSONAL SCHOOL E-MAIL ADDRESS:______
CURRENT SCHOOL TELEPHONE NUMBER: ______
CURRENT EMPLOYER: ______
Name Address Phone
MONTHLY WAGES: ______
MARITAL STATUS: ______NUMBER OF DEPENDENTS:______
OWN HOME: ______RENT: ______RESIDE WITH PARENT(S): ______
WHO REFERRED YOU? ______
WHAT HIGH SCHOOL DID/ WILL YOU GRADUATE FROM? ______
WHO WAS YOUR COUNSELOR? ______
ARE YOU PRESENTLY ATTENDING COLLEGE? ______
If yes, college attending______
HOW MANY HOURS ARE YOU PLANNING TO TAKE THIS FALL SEMESTER?______
FLC SCHOLARSHIP APPLICATION
WHAT TYPE OF WORK DO YOU PLAN TO PURSUE WHEN YOU GRADUATE? ______
HAVE YOU SERVED IN THE MILITARY? ______If so, what branch ______
GIVE THE NAME, RELATIONSHIP AND SPECIFY IF ADULT OR CHILD OF ALL PERSONS LIVING IN YOUR RESIDENCE:______
______
______
LIST EXTRACURRICULAR AND COMMUNITY SERVICE ACTIVITIES______
______
______
STATE THE TYPE OF STUDIES THAT YOU ARE NOW PURSUING OR PLAN TO PURSUE:
______
FATHER’S NAME: ______Address: ______
Phone: ______Employed by:______
Employers address: ______Phone:______
MOTHER’S NAME: ______Address:______
Phone: ______Employed by:______
Employers address: ______Phone: ______
OTHER THAN EMPLOYMENT, FROM WHAT SOURCES DO YOU EXPECT TO OBTAIN FUNDS FOR COLLEGE?
Parents______MSU______Vernon______Pell Grant or other grants______
OtherResources______
Other Scholarship Applications:______
STATE IN DETAIL THE FINANCIAL SITUATION THAT LEADS TO YOUR NEED FOR THIS SCHOLARSHIP AID:
______
TELL US ABOUT YOUR EDUCATION AND CAREER GOALS______
______
FLC SCHOLARSHIP APPLICATION
I HEREBY CERTIFY THAT THE INFORMATION GIVEN ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
______
SIGNATURE OF APPLICANT
Return completed application to:
Randy Cooper
Lions Club Scholarship Chair
1318 Sixth St.
Wichita Falls, TX 76301
WITH COMPLETED APPLICATION, PLEASE SUBMIT THE FOLLOWING:
1. Current transcript
2. One letter of Recommendation-may be from employers, teachers, clergy, community leaders or longtime friends.
Deadline to submit application is June 5.
(Revised February 2012)