LAKE PARK HIGH SCHOOL EDUCATIONAL FOUNDATION SCHOLARSHIP APPLICATION
Completed scholarship applications must be turned into
the Career Center at West Campus by Thursday, March 10, 2016.
Section A: Basic Information
Last Name:
First Name:
Middle Name:
School ID #:
Mailing Address:
City:
State:
Zip Code:
Phone Number:
Email Address:
Name of LPHS Counselor:
Please describe your work experience. Include your employer name, job title, responsibilities, dates of employment,
and hours per week.
Family Information:
Father’s Name:
Mother’s Name:
Father’s Occupation:
Mother’s Occupation:
Number of parents in home, including stepparents:
Number of siblings living at home, including stepbrothers and stepsisters:
Number siblings currently attending college:
Please explain below any specific family financial problems, challenges, or issues the selection committee should be
aware of:
Section B: Academic Information
Class Rank:
th
Cumulative GPA through 7 semester:
Section C: Future Plans
What college are you planning to attend in the fall of 2016?
Intended college major:
Intended career choice:
Please describe your reason(s) for choosing your future career:
590 South Medinah Road
Roselle, Illinois 60172-1978
630-529-4500
Check Weighted or Non-Weighted
 Weighted GPA and Class Rank
 Non-Weighted GPA and Class Rank
Section D: Athletics and Extracurricular Activities
List school activities, year(s) of involvement, year(s) of offices held, and year(s) when honors was/were received. Check
the year in school when activities occurred.
ACTIVITY
9th
GRADE
10th
GRADE
11th
GRADE
12th
GRADE
LEADERSHIP POSITION/
HONORS BY YEAR
Section E: Community Activities
List all community activities in which you participated during your high school years, year(s) of involvement, and any
leadership positions held or honors received.
PLEASE MAKE SURE YOU ATTACH THE FOLLOWING TO YOUR APPLICATION:
□ Your unofficial transcript of all high school classes taken
□ The letter(s) of recommendation from a Lake Park teacher, coach, or club sponsor (Some scholarships require two
letters of recommendation or letters from a specific subject-area teachers. Please refer to the specific scholarship
application for letter(s) of recommendation requirements.)
□ The completed the essay(s) for the scholarship for which you are applying. (See Scholarship Information Packet)
Signature of Endorsement by a Counselor or the Principal: _____________________________
Date Received By Career Center: _______________
Please be assured that all applications are treated in the strictest of confidence.
590 South Medinah Road
Roselle, Illinois 60172-1978
630-529-4500