Little Elm Lions Club - Lions e-Clubhouse

The Little Elm Lions Club

P.O. Box 234

Little Elm, TX 75068

------------------------------------------------------------------

LITTLE ELM LIONS CLUB

RULES AND REGULATIONS FOR

SCHOLARSHIP APPLICATIONS

Eligibility and Qualifications:

The applicant must be a currently enrolled LEISD Senior and scheduled to graduate in the Spring of the current year.

Scholarship payment is contingent upon acceptance by a College, University/Trade or Technical School and proof of applicant enrollment. It is the responsibility of the recipient to provide the necessary proof of enrollment.

The Lions Club MUST receive fully completed application and reference forms ALL AT THE SAME TIME and POST MARKED no later than May 16, 2016. Lack of a complete application packet will disqualify any potential applicant from being considered.

Applications and all forms submitted with the application become the property of the Little Elm Lions Club.

All scholarship money must be spent by January 1 of the year following the award of the scholarship or it will be forfeited.

Community Service is the major focus of this Scholarship and is heavily weighted in considering the beneficiary of this Scholarship. Students must submit a signed log of all Community Service hours with their Application.

I have read and agree to the terms set forth by the Little Elm Lions Club. I understand that failure to follow these terms could result in forfeiture of any scholarship that I am awarded.

____________________________________ ___________________

Applicant Signature Date

Please mail Application to Little Elm Lions Club, P.O. Box 234, Little Elm, TX 75068.

Questions may be directed to ________________________________

NAME: ______________________________________________________________________

LAST FIRST MIDDLE

ADDRESS: ___________________________________________________________________

STREET CITY STATE ZIP

HOME PHONE: ____________________________ CELL PHONE: _______________________

FATHER’S NAME: __________________________ OCCUPATION: _______________________

FATHER’S PHONE: __________________________

MOTHER’S NAME: _________________________ OCCUPATION: _______________________

MOTHER’S PHONE: _________________________

CHOICE OF SCHOOL (PLEASE CIRCLE)

___________________________________ APPLIED ACCEPTED NOT ACCEPTED

___________________________________ APPLIED ACCEPTED NOT ACCEPTED

___________________________________ APPLIED ACCEPTED NOT ACCEPTED

ANTICIPATED MAJOR ____________________________ MINOR ______________________

Have you been employed during high school? If so, briefly describe your job: _____________

_____________________________________________________________________________

As of the date of this Application, have you been awarded any Scholarships? If yes, please list source and amount.

_____________________________________________________________________________

Applicant Name _________________________________________

On a separate piece(s) of paper, please answer the following questions:

Briefly, what would this scholarship mean to you? Any additional information or comments? (unusual family situations, medical expenses, etc.)
What are your personal and career goals?
Describe any obstacles/challenges that you have addressed during your high school career.
What subject, teacher or academic experience has had the most impact on you and why?
What does Community Service mean to you? Briefly describe your Community Service activities?

PARTICIPATION AND LEADERSHIP

School activities/Organizations/Awards Year Office(s) Held or Honors

______________________________________________________________________________

Community Activities/Organizations/Awards Year Office(s) Held or Honors

______________________________________________________________________________

Describe any honors not previously listed ___________________________________________

______________________________________________________________________________

REFERENCES:

Please submit two references from LEISD counselors, teachers or administrators and one personal reference. Position/Relationship

___________________________________ __________________________________
___________________________________ __________________________________
___________________________________ __________________________________

TO BE COMPLETED BY COUNSELOR (Upon review of the completed application).

THIS FORM SHOULD BE COMPLETED IN PRIVATE AND GIVEN TO STUDENT IN SEALED ENVELOPE.

Name of Applicant __________________________________________________________

Rank in Class: _______________________ Grade Point Average: _____________

SAT Score: ____________________ ACT Score: ______________

Counselor Comments: _______________________________________________________

___________________________________________________________________________

Counselor Signature: _____________________________ Date: ___________________

If you would like a printable version of this document please Click Here.