VIENNA WOMAN'S CLUB

COLLEGE SCHOLARSHIP APPLICATION

Due April 12, 2017

This scholarship is awarded to male or femalegraduating seniors with a Vienna home address (22180 through 22182). Applicants must have applied to a 2 or 4 year college such as NOVA, George Mason or other accredited technical school with a minimum 2.5 GPA.

Name of Applicant: ______

Home Address:______

______

Phone Number: High School:______

College Choices: 1st Choice Accepted ______

2nd Choice Accepted ______

College Costs: Room and Board ______Tuition ______Total______

(Total annual estimate as listed in college catalogue)

Total Student Resources:

Scholarships and/or Awards $ Loans $ ______

Student's savings $ _ Other sources $______

Total $______

Father's Occupation: Yearly Income $______

Mother's Occupation: Yearly Income $______

Other Family Income: retirement $______annuities $______pensions $______

inheritance $______other $ ______

Please list information on dependent siblings:

Name Age Grade in School or Year in College

______

______

______

ATTACH A FINANCIAL AIDE STATEMENT:Please list any additional family responsibilities.Also, include any other relevant information and any unusualfactors which should be brought to the attention of the Selection Committee as to your need for this money.

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Continuation of Vienna Woman's Club Scholarship Application

Jobs Held While Attending High School (If none, why?)

Attach a personal letter that includes: (1)) why you chose to go to college, (2) what high school, community or other activities you have participated in, (3) what has been the most rewarding of your experiences during the past four years, (4) and your future goals.

If you are a finalist, you will be interviewed on Saturday morning,April22, 2017 No exceptions

If you are a winner, the award will be presented in June, 2017

Student's Signature Date .

I understand that my son/daughter is applying for a $2,000scholarship to meet educational expenses,

and I approve this application.

Signature of Parent or Legal Guardian Date .

This application (with all attachments) must bepostmarked by April 12, 2017

Send to: Vienna Woman's Club, c/o Jo-Lynn Westlund, 411Onondio Cir., Vienna, VA 22180

The following documents MUST be included in the mailing to the Vienna Woman's Club. If any of these 6 documents are not provided the applicant will be disqualified:

(1) Completed Application, (2) Personal Letter, (3)OfficialTranscript of High School Grades, (4)Resume of activities involved in during high school, (5) Evaluation Letter from Faculty Member, (6) Copy of the filedStudent Aid Report (SAR).

All college financial grant applications answers are confidential. This form will be destroyed after the award is made.

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