North Central Kiwanis Memorial Fund Tuition Scholarship Application Instructions
The North Central Kiwanis Memorial Fund Tuition Scholarship application is available to all Kiwanis Camp Casey counselors or nurses. Applicants must be students currently enrolled in an accredited program at a college, university, or technical program. Application deadline is: September 15, 2014. Completed applications along with a photo of yourself must be submitted as attachments via e-mail to: director@campcasey.org
. The winning applicants will be notified by email the second week of October with funding awarded by the end of October. Award monies will be placed directly into the school account of the scholarship recipient.
NC Kiwanis Camp Casey Counselor Tuition Scholarship Application
Applicant’s Name: __________________________________________________________________________________
(Last) (First) (Middle)
Permanent Address: ________________________________________________________________________________
(Street) (City) (State) (Zip)
Telephone: ( ) _____________________ Cell: ( ) _______________ Email: ________________________________
Siblings and Ages: ___________________________________________________________________________________
Does your school have a Key Club? _____________ Have you been a Key Club, Circle K or member of Kiwanis? ______
If yes, for how long? Please detail your service with Kiwanis: _______________________________________________
Education Information:
School Now Attending: ______________________________________________________________________________
Date of Entrance: ___________________ Grade Level: _____________
In the event you are selected, provide the address, and if appropriate, your account number, your scholarship award should be mailed: __________________________________________________________________________________
Major/Educational Goals: ____________________________________________________________________________
Extra Curricular Activities: ____________________________________________________________________________
What are your special abilities and talents?
What are your hobbies and personal interests?
What will be your source of income for your education?
What are your career plans?

Name: _________________________________page 2
Camp Casey History
How many years have you been involved in Camp?
Have you held a leadership position at Camp? ________If so, please describe:
Where do your strengths lie at Camp?
What are you anticipating as your greatest challenges to reaching your academic goals?
Length of essay may range from one paragraph to no more than 300 words .
Applications must be postmarked or received via email (preferred) on or before September 15, 2014
□ by checking this box, I confirm that to the best of my knowledge, the information is accurate and true.
Signature: ________________________________________ Date: _______________________________