Self-Inventory
Name ___________________________________
Purpose:
Date _____________________
Scholarship Application
Education
1.
Current institution: ___________
Program of study:
Projected date of completion: ______________________
__________________
Other institution(s) attended: ________________________________________________
________________________________________________________________________
2.
Highest level of education: GED ( )
High school diploma ( )
Technical/trade school ( ) _____________ Certificate/Diploma ( ) ________________
Other ( ) __________________________
3.
Important/relevant courses that you have taken (as it relates to your career interest and the
scholarships you are applying for).
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4.
Skills acquired as a result of educational experiences:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
5.
Will you be the first in your family to attend or graduate college? ________
6.
What are your career goals? Why did you select this field? What/Who influenced your
career choice?:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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Work Experience
Employer #1: ________________________
Job Title:
________________________
Name of Immediate Supervisor:
_______________________ Contact #: _______________
Job Duties/Responsibilities: ______________________________________________________
Skills acquired:
____________________________________________________________
Employer #2: ________________________
Job Title:
________________________
Name of Immediate Supervisor:
_______________________ Contact #: _______________
Job Duties/Responsibilities: ______________________________________________________
Skills acquired:
____________________________________________________________
Employer #3: ________________________
Job Title:
________________________
Name of Immediate Supervisor:
_______________________ Contact #: _______________
Job Duties/Responsibilities: ______________________________________________________
Skills acquired:
____________________________________________________________
Volunteer Experience/Community Service
(List participation in activities focusing on
volunteering and serving the community. Be sure to list any leadership positions held)
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Extracurricular Activities (List participation in school clubs such as SGA, Phi Theta Kappa,
Literary Club. Be sure to list any leadership positions held.)
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
Activity/Group:
_____________
Your role:
___________ Date(s): __________
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Honors/Awards
(List any awards or honors since high school)
Honor/Award: _____________________________________________
Date: ____________
Honor/Award: _____________________________________________
Date: ____________
Honor/Award: _____________________________________________
Date: ____________
Honor/Award: _____________________________________________
Date: ____________
Honor/Award: _____________________________________________
Date: ____________
Honor/Award: _____________________________________________
Date: ____________
Hobbies/Interests
(List hobbies or interests that you think will highlight your skills,
capabilities, or character. Please include those that may be aligned with the scholarship you
select.)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Skills acquired (as a result of Volunteer/Community Service, Extracurricular, Hobbies)
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
What are your proudest accomplishments?
A. Academic?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
B. Personal?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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List five words that describe you (Think of words that may be aligned with your career
goals/focus of the scholarship. For example, nurses are expected to be compassionate,
empathetic, efficient, “people persons”, and gentle.)
1.
2.
3.
4.
5.
________________________
________________________
________________________
________________________
________________________
Is there anything else you think that might help the scholarship committee understand why
you are applying for the scholarship and how will it be of benefit (e.g. challenges, obstacles,
financial need, special circumstances, family situation)?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
References (List three people who will give you a favorable recommendation. Please do not
list family members. Consider a co-workers, classmates, faculty/staff, community contacts.)
#1
Name: __________________
Phone: ______________
Title:_____________
Address:
_________________________________________ Email:__________________
#2
Name: __________________
Phone: ______________
Title:_____________
Address:
_________________________________________ Email:__________________
#3
Name: __________________
Phone: ______________
Title:_____________
Address:
_________________________________________ Email:__________________
Note: It is recommended that students complete the self-inventory prior to tackling scholarship
applications.
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