2014-2015 COMPLETE Application
About the Program
The Rotary District 6820 Global Scholar Program provides $30,000 scholarship awards for graduate studies outside the USA. Scholars must expend the scholarship funds within 12 months of starting studies after receiving funds.
Eligible applicants will have a demonstrated record of high academic achievement and a reasonable level of proficiency in the language of the region of study.
Required Areas of Focus
In anticipation of The Rotary Foundation’s (TRF) 100-year anniversary in 2017, the TRF Trustees set out to develop a plan to move the foundation toward its second century of service. The plan, called the Future Vision Plan, focuses TRF-funded programs to specific areas where they will have the greatest impact by addressing priority world needs that are presently most relevant to Rotarians.
As a result, to be eligible for a Rotary District 6820 Global Scholarship, you must have a background, intended graduate studies and future career plans related to at least one of the following focus areas:
1. Peace and Conflict Prevention/Resolution
2. Disease Prevention and Treatment
3. Water and Sanitation
4. Maternal and Child Health
5. Basic Education and Literacy
6. Economic and Community Development
Timeline for Application Submission and Review
• March 15, 2015 – Complete Application Deadline
• April 18, 2015 – In-Person Interviews
• May 2015 – Notice of Preliminary Selection
• July 2015 – Notice of Final Selection
• July 2015 – Scholar Final Forms and Orientation
• August 2015 – Scholar Makes Travel Arrangements
• September 2015 – Begin Studies (quarterly progress reports)
• September 2016 – Complete Studies
• October – December 2016 – Share Experience at 6 District Clubs
District 6820 will not review incomplete applications nor waive the requirement for an in-person interview.
General Qualifications
Please review each statement below and check ALL that apply.
q / I have (1) previous work experience, volunteer experience and/or education; (2) intended graduate degree studies; AND (3) future career plans, that are related to one of the 6 Areas of Focus established by Rotary International.q / I plan to enroll in a graduate level program commencing between September 1, 2015 and September 30, 2016 and expend the scholarship funds within 12 months of starting studies.
q / My study institution is located in a geographic area that has a Rotary presence. There are 34,000 Rotary clubs within 530 Rotary districts around the world. Despite this extensive reach, there are some parts of the world that do not have a formal Rotary presence due to security, safety or other issues. For further guidance, see: https://www.rotary.org/en/search/club-finder
q / I am NOT (1) a Rotarian; (2) an employee of a club, district, or other Rotary entity, or of Rotary International; (3) the spouse, a lineal descendant (child or grandchild by blood or stepchild legally adopted or not), the spouse of a lineal descendant, or an ancestor (parent or grandparent by blood) of any person who has been in the foregoing two categories within the past three years.
q / I currently work in, attend school in, or am a resident of District 6820 (which spans certain municipalities and counties in Mississippi, USA). For further guidance, see: http://www.clubrunner.ca/Portal/Home.aspx?did=6820.
q / I have, or will have, sufficient funds to cover any expenses throughout my scholarship time that exceed US$30,000.
q / I will attend an orientation and work with a designated Scholar mentor to prepare for my program before traveling.
q / I will endeavor to participate in a humanitarian project sponsored by the host Rotary club in my study region.
q / Throughout my scholarship time, I will report my experiences no less than bi-weekly on an Internet blog.
q / I will complete all required reports during and after my scholarship time.
q / I will make a presentation about my scholarship experience to at least 5 Rotary clubs within 1 year after the completion of my scholarship program.
q / If I return to District 6820 after my scholarship, I will support future programs by serving on the Rotary District 6820 Global Scholarship Committee for at least one year.
If you did not check ALL items above, you are not eligible for the Rotary District 6820 Global Scholarship.
Applicant Profile
Personal Information
First name:
Family name:
Citizenship:
Date of Birth:
Gender: q Male q Female
Contact Information
Email address:
Street address or P.O.
Box, Suite, unit,
building, floor, etc:
City:
Postal code:
Country:
Primary telephone:
Secondary telephone:
Languages Skills
List all languages you speak, including your native language:
Language / Written Proficiency / Spoken ProficiencyEmergency Contact Information
First name:
Family Name:
Relationship:
Email address:
Street address or P.O.
Box, Suite, unit,
building, floor, etc:
City:
Postal code:
Country:
Primary telephone:
Secondary telephone:
Rotarian Contact (if you have one):
Name:
Telephone:
Email:
Rotary club:
Prior Education
List the two educational institutions you have most recently attended:
Most recently attended
Name of institution:
Degree received:
Place of study:
Field of study:
GPA:
Previously attended
Name of institution:
Degree received:
Place of study:
Field of study:
GPA:
Summary & Objectives
In 2-3 short sentences, tell us your objectives for this scholarship (study/degree sought, Rotary area of focus, etc.).
Who will benefit from this global grant? (You, certain Rotary Clubs, beneficiaries of services projects, etc.)
In 200 words or less, please summarize your qualifications to receive this scholarship. (volunteer/work/study experience, philosophy and perspective, etc.)
Areas of Focus
Scholarships must support the goals of at least one of Rotary’s areas of focus:
7. Peace and Conflict Prevention/Resolution
8. Disease Prevention and Treatment
9. Water and Sanitation
Maternal and Child Health
Basic Education and Literacy
Economic and Community Development
For detailed information on Scholarship focus area requirements see: https://www.rotary.org/en/areas-focus.
What is your area(s) of focus?
What are the focus area goals your scholarship activities will support?
How will you meet these goals?
Scholarship Information
Provide the following information about the academic program you plan to attend:
Name of institution:
City:
Language of instruction:
Website:
Academic program:
Academic program start date:
Academic program end date:
Planned departure date:
Planned return date:
List the classes you plan to take and provide any relevant links to information about the program.
How does your educational, professional, or volunteer experience align with Rotary's goals in the selected area of focus (500 words or less)?
What are your plans immediately after the scholarship period (500 words or less)?
How do your long-term professional goals align with Rotary's goals in the selected area of focus (500 words or less)?
Other Participants
Rotary Clubs
The scholarship requires two sponsor Rotary sponsors:
1. Primary Host Sponsor – A Rotary club or district in the country or geographical area in which you will be studying.
2. District 6820 – A club within District 6820 in Mississippi.
Both international and local clubs can be searched here: https://www.rotary.org/en/search/club-finder
Each sponsor must establish a three-person committee in support of the scholarship, and one individual on the committee must be designated as the primary contact.
Please list the members of the committees below:
Primary Host Sponsor Committee Members
# / Role / Name / District / Club1 / Primary Contact
2 / Secondary Contact
3 / Secondary Contact
District 6820 Sponsor Club Committee Members
# / Role / Name / District / Club1 / Primary Contact / Member of sponsoring Club in District 6820
2 / Secondary Contact*
3 / Secondary Contact
* The Secondary Contact for District 6820 must currently serve on the Rotary District 6820 Global Scholarship Committee.
No sponsor Rotarian with a vested interest in the activity (e.g., an employee or board member of a cooperating organization, owner of a store where project goods will be purchased, trustee of a university that a scholar plans to attend) may serve on the grant committee. If any potential conflict of interest exists, disclose it here.
Host Counselor
The host counselor provides support for the scholar before and during the scholarship period. Please identify who will serve as your host counselor:
Partners
List any additional partners who will participate and identify their responsibilities. This may include Rotary clubs, Rotaract clubs, Rotary Community Corps, or individuals (only if applicable; not required for all)
Describe the role of District 6820 Rotarians in this activity and list their specific responsibilities.
Describe the role that members of the local international community will play in implementing your project. (If applicable)
Budget
Select the local currency for your budget and enter the current rate of exchange to 1 U.S. dollar.
Local currency: ______
Exchange rate to 1 USD: ______
Detail your proposed expenses. Note that the total budget must be equal to the total financing of your activity. Attach any documents, such as price sheets, bids or estimates, to support the expenses listed.
No. / Description / Category / Local cost / Cost in USD1. / Tuition & Fees / Tuition
2. / Local Housing / Accommodations
3. / Books / Supplies
4. / Food / Supplies
5. / Health Insurance / Supplies
6. / Business Cards / Supplies
7. / Website / Publicity
8. / Airfare / Travel
9. / Consular/Visa Fees / Travel
10. / Local Transportation / Travel
11.
12.
13.
14.
15.
Total Budget / $
Financing
The scholarship amount is US $30,000. You are personally responsible for all expenses in excess of the scholarship amount. Please list and describe your sources and sufficiency of additional funds that will cover the balance of your budget:
Agreement
I will accept a scholarship granted by The Rotary Foundation (TRF) for study during the predetermined academic year(s) at the study institution approved by TRF.
I acknowledge that (if selected), TRF will provide me a scholarship as described below. In accepting this scholarship, I understand and agree that:
1. I have been provided with a copy of the Terms and Conditions for Rotary Foundation District Grants and Global Grants (“Terms and Conditions”) and will adhere to all policies that apply to scholarships and the proper use of the funds awarded by TRF.
2. I am not: (1) a Rotarian; (2) an employee of a club, district, or other Rotary entity, or of Rotary International; (3) the spouse, a lineal descendant (child or grandchild by blood or stepchild, legally adopted or not), the spouse of a lineal descendant, or an ancestor (parent or grandparent by blood) of any person in the foregoing two categories.
3. My scholarship is provided for direct enrollment at the approved study institution, and my award funding is intended to defray my expenses only during my scholarship period as approved by TRF. No other person’s expenses, either directly or indirectly, will be covered by my award funding.
4. Depending on tax laws in my home and host countries, the scholarship may be taxable to me in part or in full, and I acknowledge that I am solely responsible for investigating and paying all taxes that pertain to the funding of my scholarship or otherwise result from residency in my home country.
5. I will live in the immediate vicinity of my approved study institution and in my host district so that I can participate in the Rotary club and district activities of my host district.
6. Deferral or postponement of studies after the scholarship study period has begun will not be considered or approved.
7. The duration of this scholarship is for consecutive terms within the approved scholarship period at the study institution; this scholarship is only for the graduate level (or equivalent) program(s) approved by TRF; and under no circumstances will this scholarship be extended beyond the approved time period.
8. I will be responsible for arranging travel to and from the study institution and will follow all travel policies listed in the Terms and Conditions.
9. I will keep my international and host sponsors and my global grant coordinator at TRF advised of my current mailing address, telephone number, and e-mail address at all times before, during and after my study period.
10. I will participate in mandatory pre-departure orientation activities offered by the sponsor Rotary club or district and club and district activities during the term of my scholarship as requested by my sponsors.
11. I will submit progress reports every 12 months for the term of my scholarship including a final report one month before completion of my scholarship period. I will send copies of my reports to TRF and the sponsoring Rotary clubs or districts.
12. I will exercise good judgment in expressing opinions regarding controversial, political, racial, or religious issues so as to avoid offending others. In addition, I will abide by the local laws of my host country.
13. Rotary International (RI), TRF, my approved study institution, and any Rotary district, club, or individual Rotarian are in no way responsible for enabling me to pursue my studies beyond my scholarship period. If I choose to pursue studies beyond that period, all expenses will be my responsibility.
14. I will refrain from engaging in dangerous activities for the entirety of the scholarship period. I further confirm that I understand and agree to the following:
· I am solely responsible for my actions and property while participating in and traveling to and from grant activities.
· While participating in this scholarship, I may be involved in some dangerous activity including exposure to disease, injury, sickness, inadequate and unsafe public infrastructure, unsafe transportation, hazardous work conditions, strenuous physical activity, inclement weather, political unrest, cultural misunderstandings, issues resulting from noncompliance with local laws, physical injury or harm, and crime and fraud. I understand these risks and assume all risks involved with this scholarship.
· I do hereby release RI/TRF from any liability, responsibility, and obligation, either financial or otherwise, beyond providing the grant.
· I shall be solely responsible for any and all costs and damages for any illness, injury, or other loss (including loss of consortium and emotional loss) incurred or suffered participating in, traveling to or from the grant activity, or otherwise related to the provision of the grant.