Please mail transcripts to: Required items:
Completed application form School transcript Two (2) completed recommendation forms PLEASE TYPE ALL INFORMATION REQUESTED (check boxes)Please select the scholarships of your choice: Vineland Rotary Harry D. Doerr Scholarship John Spoltore/Matt Blatt Most Inspirational Scholarship Harry Kejzman Scholarship Loyle Lanes Scholarship Vineland High School William F. Dudley, Sr. Memorial Scholarship Vineland High School Otto Schwabe Memorial Scholarship Sacred Heart High School Msgr. Joseph G. Stoerlein Scholarship Rev. C. Ross Collins Scholarship Leslie N. Kotok Scholarship Shaye Kotok Scholarship The Grapevine's Hometown Heroes Scholarship Full Name: Last Birth Date: (mm/dd/yyyy) Citizenship status: Residency status: Gender: Permanent Home address City Zip Home phone: (numbers only) Work/School phone: E-mail address: High School Applicant only: High school:(attending or graduated from) High school Address: Date of high school graduation: (mm/dd/yyyy) Best SAT scores: Critical Reading: Current High School Class Rank: GPA: Best ACT scores: COMP: College Applicant only: College (attending): College Address: College Year: Year of College Graduation: College GPA: Cumulative Household: Parents’ marital status (relative to each other): With whom do you make your permanent home? If you have children, how many? Parent 1: Is Parent 1 living? Name (Last,First,Middle,Title) : Country Of Birth Home address if different from yours Preferred Telephone: Area/Country/City Code E-mail Occupation Employer College (if any) Degree Graduate School (if any) Degree Parent 2: Is Parent 2 living? Name (Last,First,Middle,Title) : Country Of Birth Home address if different from yours Preferred Telephone: Area/Country/City Code E-mail Occupation Employer College (if any) Degree Graduate School (if any) Degree Legal Guardian (if other than a parent) Relationship to you Name (Last,First,Middle,Title) : Country Of Birth Home address if different from yours Preferred Telephone: Area/Country/City Code E-mail Occupation Employer College (if any) Degree Graduate School (if any) Degree Siblings Please give names and ages of your brothers or sisters. If they are enrolled in grades K-12 (or international equivalent), list their grade levels. If they have attended or are currently attending college, give the names of the undergraduate institution, degree earned, and approximate dates of attendance. If more than three siblings, please list them in the Additional Information section. Name, Age & Grade, Relationship College Attended Degree earned or expectedmm/yyyy–mm/yyyy Name, Age & Grade, Relationship College Attended Degree earned or expected mm/yyyy–mm/yyyy Name, Age & Grade, Relationship College Attended Degree earned or expected mm/yyyy–mm/yyyy Additional Information (include names and ages only of additional siblings): Where have you applied? Your first choice of college: Total cost per year: Your intended major: Your career goal: List Summer job(s) you had in the summer of 2011 If you didn't work, explain how you spent your summer List Summer job(s) planned for the summer 2012 If you're not planning to work, explain how you plan to spend your summer Are you currently working? If yes, where? What is YOUR financial contribution toward your expenses? (numbers only) Expected assistance from parents/family: (numbers only) Scholarship work study: Grants/Scholarships: Work study: Loans: List extra-curricular activities, clubs, sports, and offices held, including any community service. Freshman year: Sophomore year: Junior year: Senior year: Provide an essay of 250-500 words. The essay portion of this application accounts for 40% of your score in the overall review and final selection process. Provide information in 250 words or less. The Vineland Rotary Education Committee is very interested in your personal family situation. Tell us why your need for one of our scholarships is so unique. What circumstances can you tell us about that will give us insight into your need for financial assistance to further your education. Please be as specific as possible. Recommendation Forms:The official Recommendation Form must be completed and electronically submitted. 1. 2.
