Meetings

                                                                                    (Revised 10/08/2012)                                                                                                 

Richmond Lions Club

P.O. Box 931

Richmond, KY  40476

 

Scholarship Application

 

All questions must be answered.

 

Name:_______________________________________________Birthdate:______________

 

e-mail:______________________________Telephone:______________________________

 

Permanent Home Address:_____________________________________________________

 

City: _______________________________ State: __________  Zip: ___________________

 

College Attending:____________________________________________________________

 

Address of College:___________________________________________________________

 

City: _______________________________ State: __________  Zip: ___________________

 

Cumulative Grade Point Average _________    ACT Composite _______    SAT __________

 

Standing in graduating class _____of_______

 

Expected Graduation/Certification Date: ___________________________________________

 

The following must be included as attachments to the application form:

 

  1. An essay of no more than two (2) pages that will provide the scholarship committee with a “snapshot” of your life.  It may include but is not limited to a description of your academic achievements, academic/career plans, extracurricular and community activities, awards and other recognition you have received, and your reasons for applying for this scholarship.
  2. Three (3) letters of reference from three persons not related to you.  
  3. An official transcript.

 

By signing this application, I affirm that information contained herein is correct to the best of my knowledge.  I grant permission to the Richmond Lions Club Scholarship Committee to verify all information and contact any of the provided references.

 

The application must be returned to the Richmond Lions Club, P.O Box 931, Richmond, KY.

 

__________________________________________                        ____________________

Applicant signature                                                                             Date

 

Application Deadline:  March 15.

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