Scholarship Application
Crystal Lake Central High School – 2015
All applicants will be considered for the following scholarships by
completing this application.
*CL Dawnbreakers Rotary/Scott Mueller Memorial
*CL Service League
*Paul H. Frederick Memorial (Home State Bank)
*CLC Booster Club
*Lions Club of CL
*LifeSource Blood Center
Please check below if you intend to apply for this scholarship.
____ Brent William Thomas Memorial Scholarship for Visual Arts
(portfolio is necessary)
Interviews with local organizations will take place Tuesday, April 14th. If you
are selected to interview you will be notified of the interview time at a later
date. Each interview will be approximately 10 minutes long. If athletics and
extracurriculars would conflict with interview times after the end of the
school day, notify me immediately so that I may schedule your time before
2:50 pm. All applicants will not necessarily be eligible for all scholarships.
The criteria under which individual applicants will be considered for each
scholarship are on the following pages.
Due no later than
Thursday March 12th at 3 PM
Please return to the Career Center to Ms. Allen
Local Scholarship Application
Crystal Lake Central High School – 2015
Name: ________________________
Parents’ names:___________________________________
Address: _____________________________________________________________________
Phone Number: _______________(home) _______________ (cell) email: ___________________
ACT Score: _______
SAT Score: _______
GPA: _______ Class rank: _______ out of _______
College you’ll probably be attending: ___________________ Have you been accepted? ___yes ___no
Intended major or career goal: ______________________________________________________
Do you have a parent or grandparent who is/was a U.S. veteran?
___ Yes
___ No
What extra-curricular activities have you been involved in at school? Any leadership roles?
Have you done any volunteer work and/or outside-of-school activities? What? (include jobs for pay)

Resume attached
Are you a blood donor?__________
Optional essay attached (required for Scott Mueller and CLC
Booster Club scholarships only)
If yes, how often do you donate?______________________
Assume hundreds of other students are applying for the same scholarships. Are there special reasons
you are more deserving? Please explain why you feel you should be selected to receive a scholarship.
Total parent income reported to IRS in 2013: ___ $0 - $20,000 ___ $20,000-$50,000
___ $50,000 – $75,000 ___$75,000-$100,000 ___ $100,000-$150,000 ___ $150,000+
Father’s occupation: _____________________ Mother’s occupation: __________________
Number of children in your family (excluding you) ____
Number of siblings currently in college _____
Tentative College Costs
Tuition (per year)
$_________________________
Room & Board
$_________________________
Books & Fees
$_________________________
Total
$__________________________
List scholarships, grants
$__________________________
or gift aid you’ve received
(do NOT include loans or
$___________________________
work study)
financial aid from your school $___________________________
Total Aid
Money you’ve
saved for college
$___________________________
$___________________________
How do you plan to pay for costs not covered by the above?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Is there anything else you feel we should know?
APPLICATIONS ARE DUE IN THE CAREER CENTER BY 3:00 PM Thursday March 12th, 2015
Interviews will take place Tuesday, April 14th…… Put that on your calendar!
Local Scholarship Descriptions
Crystal Lake Dawnbreaker Rotary/Scott B. Mueller Memorial Scholarship
~ Non-renewable
~ Two $1,000 scholarships awarded
~ Must be attending a 4 year college or university in the fall
~ 3.0 minimum GPA
~ For well rounded students who have demonstrated citizenship through participation in
extra-curricular activities at Central High School and in the community. Essay required
written on a volunteer or community service experience and how the experience
affected your life and the lives of those around you.
Paul H. Frederick Memorial (Home State Bank) Scholarship
~ Non-renewable
~One $1,000 scholarship
~Anyone attending a college or university majoring in business
CL Service League
~ Non-renewable
~ Number and amount of scholarships varies
~ Demonstrated service to the community
~ Must be attending a 2 or 4 year college or university. Financial need is considered.
Life Source Blood Center Scholarship
~Non-renewable
~ Amount will vary
~must be a 4 time blood donor
~3.5 GPA or higher and demonstrated service to school and community
Brent William Thomas Memorial Scholarship for Visual Arts
~ Renewable
~ One $1,000 scholarship
~ Has excelled in the visual arts and academically. Intending to major in the visual arts,
portfolio required, separate interview.
CLC Booster Club
~ Non-renewable
~ Number and amount of scholarships will vary
~ Demonstrated outstanding volunteer service to the school during their years at
Central. Should display a certain level of leadership and commitment to community
service. Essay required written on a volunteer or community service experience and
how the experience affected your life and the lives of those around you.
Lions of Crystal Lake Foundation Scholarship
~ Non-renewable
~ One $1,000 scholarship
~ Student who is interested in a career working with blind and/or deaf, physically or
mentally handicapped individuals or interested in a career as a nurse, EMT, fire fighter
or police officer.
~ or a student who is legally blind and/or hearing impaired