THE OPTIMIST CLUB OF WESTMINSTER

2008 SCHOLARSHIP APPLICATION

ELIGIBILITY INFORMATION

STUDENT INFORMATION                     PARENT/GUARDIAN

Name: ____________________________              Name: _________________________
Address: __________________________               Address: _______________________
City: _____________________________               City: __________________________
State: ____________________________                State: __________________________
Phone: ___________________________                Phone: _________________________
Graduation Date: ___________________

Post High School Plan

Briefly describe your post high school educational plan.
________________________________________________________________________________________________________________________________________________________________________________________________________________________

Have you applied for any program of further education?  Yes ____  No ____
If yes, please identify ________________________________________________________________________
Have you been accepted?  Yes ____  No ____ 

Criteria Information

Please list your involvement as a volunteer or participant in your school, community, church, recreational work or family activities (add additional sheets as required)

Involvement/Program Activity/Jobs                   Dates               Brief Description

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

2008 JSN SCHOLARSHIP APPLICATION

THE OPTIMIST CLUB OF WESTMINSTER

www.westminsteroptimist.org

Criteria Information

II.   Combined family income  $______________________
III.  Have you applied for any other scholarships?

            Scholarships applied for                        Amount            Awarded (Yes or No)

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

IV.Academic Record   

     Cumulative G.P.A. _________ Weighted G.P.A. ________ (attach copy of transcript)

V.Recommendations

High School
Name: __________________________  Title: ___________________________

Non-School
Name: __________________________  Title: ___________________________

Student’s Signature             _______________________ Date: ____________

Parent/Guardian Signature  _______________________ Date: ____________