Walworth Fontana Rotary Club
2012 Scholarship Program
2 0 12 Wa lw orth Fonta na S c hola rs hip G ui de l i nes
Scholarship Awards
Scholarships will be awarded to successful applicants based on need and achievement in both their
personal and academic lives.
Eligibility Requirements
o
Applicant must be a graduating senior, have graduated from a Wisconsin high
school, or have been home schooled and be 21 years of age or less
o Applicant must be a resident of the Walworth Fontana Rotary Club’s service
area, which is defined as Fontana, Village and Town of Walworth, Williams Bay,
Village and Town of Sharon, and the Town of Linn.
o Applicant must be pursuing a full time course of studies at an accredited college or university
or state operated vocational/technical school
o Applicants accepted to one of the government military academies are not eligible to apply
Selection Criteria
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Scholastic and academic achievement
Financial need and family circumstances as expressed in the applic ants statement
Ability to articulate career plans
Extracurricular activities
Community involvement
Other work experience
Demonstrating that they have lived their life by demonstrating the Rotary 4 way test:
o Is it the truth?
o Is it fair to all concerned?
o Will it build goodwill and better friendships?
o Will it be beneficial to all concerned?
Awarding of scholarships will be the responsibility of the Walworth Fontana Rotary Club
Scholarship Committee, or a separate committee appointed for this specific purpose by the Board
of Directors.
Selection of scholarships shall be at the sole discretion of this committee. All applications will be
considered without regard to the applicant's age, sex, race, religion, handicap or other protected
categories. All applications and judging records are confidential and are the property of the Walworth
Fontana Rotary Club. Information about the award decision process will NOT be made available.
Granting of awards is dependent upon receipt of qualified applications. Incomplete applications will
not be considered.
2 0 12 Wa lw orth Fonta na S c hola rs hip G ui de l i nes (c onti nue d)
Completed applications must be postmarked on or before April 20th, 2012.
Please send completed applications to:
Walworth Fontana Rotary Club
Attn. John Ring
P.O. Box 368
Walworth, WI 53184
Phone 262-275-6175
Email: jring@dalcometals.com
2012 Walworth Fontana Rotary Club Scholarship Application
Please type or print all information
Applicant Information
Name: ____________________________________________________________________
Home Address: _____________________________________________________________
City, State, Zip: _____________________________________________________________
Phone ______________________________ Email: _______________________________
Father’s Name: _____________________________________________________________
Father’s employer & occupation:________________________________________________
Mother’s name: _____________________________________________________________
Mother’s employer & occupation: _______________________________________________
Number and ages of siblings living at home: _____________________________
Number of siblings attending post-secondary school: ______________________
Academic Information
High School Name __________________________________________________________
N/A for home schooled students
Class Rank: ________________ in a class of students _____________________________
ACT or SAT score:_________________ GPA: __________ on a scale of ______________
Post-High School Plans
List the colleges and/or technical colleges to which you have applied in order of preference:
1. ________________________________________________________________________
2. _______________________________________________________________________
Estimated cost of school for one year: Do you intend to live on campus? _______________
How do you intend to pay for college? (circle all that apply)
1. Parent/guardian assistance Personal savings Scholarships
2. Student loans Grants
3. Work during school (include estimated hours/week) _________________________
4. Other (please specify) ________________________________________________
High School or Post High School Work Experience –
(Include additional pages as necessary)
Employer(s): ______________________________________________________________
Type of work: ______________________________________________________________
Hours/week: ______________________________________________________________
HIGH SCHOOL OR COMMUNITY ACTIVITIES –
(include additional pages as necessary)
Activity _________________________________________________________________
Years of Participation _____________________________________________________
Honors/Awards Offices Held _______________________________________________
Please provide the following information along with this form:
1. A one page, typewritten essay of 250 words or more, specifying reasons why you should be
awarded a scholarship. Include information regarding the following:
a. Career goals and aspirations
b. Academic achievement
c. Financial need/elaborate on any extenuating family circumstances
d. Work experience
e. Extracurricular activities/community involvement
f. How you have incorporated the Rotary 4 way test into your life.
2. A copy of your academic transcript of high school credits through the most recently completed
semester of study.
3. A completed recommendation letter from an authorized school official (principal, vice principal,
guidance counselor. The form may be mailed directly to the Walworth Fontana Rotary office by the
school, or included with the main application.
All sections of this application must be completed. Incomplete applications will not be
considered.
By signing this document, I attest that all the information provided, as part of the application
process, is complete and accurate.
I agree to follow scholarship rules. I understand that awards are granted at the sole
discretion of the Walworth Fontana Rotary Club.
I acknowledge that all records and the decision process itself are the confidential property of
the Walworth Fontana Rotary Club.
Signature of Student Applicant
Signature of Parent or Guardian