Walworth Fontana Rotary Club
2013 SCHOLARSHIP PROGRAM
GUIDELINES and APPLICATION
2 0 13 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 achievement and need in both their personal
and academic lives.
Eligibility Requirements
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Applicant must be a graduating senior, have graduated from a W isconsin high
school, or have been home schooled and be 21 years of age or less
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.
Applicant must be pursuing a full time course of studies at an accredited college or university or state
operated vocational/technical school
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 applicants statement
Ability to articulate career plans
Extracurricular activities
Community involvement
Other work experience
Demonstrating that you have lived your 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.
Completed applications must be postmarked on or before April 26th, 2013.
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
2013 Walworth Fontana Rotary Club Scholarship Application
Please type or print all information
Award applying for (please mark one category only):
 Financial Need
 Academic / Achievement
 Technical College
I. 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: ______________________
II. 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 ______________
III. Post-High School Plans
What is your intended career goal? ______________________________________________
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? (Estimate percentage of all that apply)
Parent/guardian assistance ________ Personal savings ________ Scholarships ________
Student loans ________ Grants ________
Work during school (include estimated hours/week) _____________________________
Other (please specify)
________________________________________________
IV. Work Experience (Include additional pages as necessary or
substitute spreadsheet for paid activities)
Employer(s): ______________________________________________________________
Type of work: ______________________________________________________________
Hours/week: ______________________________________________________________
V. Extracurricular Activities and Volunteer Work
(include additional pages / spreadsheet as necessary – paid
activities should be listed in section IV)
Activity _________________________________________________________________
Years of Participation _____________________________________________________
Honors/Awards Offices Held _______________________________________________
VI. Essay
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.
b.
c.
d.
e.
f.
Career goals and aspirations
Academic achievement
Financial need/elaborate on any extenuating family circumstances
Work experience
Extracurricular activities/community involvement
How you have incorporated the Rotary 4 way test into your life.
VII. High School Transcripts and Recommendation Letters
1. Provide a copy of your academic transcript of high school credits through the most recently
completed semester of study.
2. Include a recommendation letter from an authorized school official (principal, vice principal,
guidance counselor, or teacher) directly with the application packet.
VIII. Applicant and Guardian Signatures
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 and 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