SCHOLARSHIP APPLICATION FORM

 

ELIGIBILITY LIMITED TO CURRENT GRADUATES OF KINGSTON HIGH SCHOOL and CURRENT GRADUATES OF ONTEORA HIGH SCHOOL RESIDING IN HURLEY, WEST HURLEY, OR GLENFORD

Date:   ________________________________________________________________________ 

Name: ________________________________________________________________________

Telephone Number:  _____________________________________________________________

Address: _______________________________________________________________________________________________________________________________________________________________

 

WHAT IS LIONS INTERNATIONAL?

We Serve…Whenever a Lions club gets together, problems get smaller. And communities get better. That's because we help where help is needed – in our own communities and around the world – with unmatched integrity and energy.

 

The Hurley Lions Club awards four scholarships of $1,000 to four (4) applicants who meet the basic requirements and who then attain the highest scores based upon a merit point system of your community and school activities.

 

BASIC REQUIREMENTS:  Applicant Must:

1.  Be a graduating student in the Kingston or Onteora School Districts (see eligibility above) (or home or private schooled).
2. Have a current ‘B’ average or better.
3. Have written acceptance from a post-high school educational institution.

These basic requirements may be waived only if there is no other student who meets all or at least a portion of these requirements.  (For example, if there are no applicants who have ‘B’ averages or higher, then the requirement may be waived by the Hurley Lions Club Scholarship Committee.)  If there are no applicants who meet the basic requirements, then the committee may elect to proceed solely upon the merit points.

 

Points will be determined by the committee.  Points indicated on the form are examples and for information only.  Check all applicable items and provide a separate list detailing each activity (years involved).  Be sure to include any other activities in which you have participated if not listed here.  Give dates when appropriate on all listed items.

 

Membership in School Education and Academic Achievements (List separately) (up to 3 points each activity)

______ Onteora; High Honors    Kingston; Highest Honors

______ Onteora; Honors             Kingston; High Honors

_____   Onteora; Merit                Kingston; Honors

_____ AP Courses  (Please list):  __________________________________________________

 

______________________________________________________________________________

 

 

Extra Curricular School Athletics and Other Activities (List separately all activities per year) (up to 2 points each activity)

_____  Sports and Varsity Letters

_____  Scholastic Activities (Debating, Math, Language clubs, etc.)

_____  Music/Theatrical (Bands, Choirs, Acting Club)

 

Community Service  List other activities you have been involved with and give year.  (up to 5 points each activity)

_____  Fire Department

_____  Ambulance Squad

_____  Other

 

Local Youth Community Organizations (Indicate year and list other community groups (up to 5 points each activity)

_____  Girl Scouts                              _____  DECA                                                 ____  ______________________

_____  Girl Scout Gold Award           _____  Fire Cadets                                         _____  _____________________

_____  Harvard Model Congress        _____BSA                                                      _____  _____________________

_____  Boy Scouts Eagle Award        _____ Religious Youth Groups                      _____  _____________________

_____  4-H                                          _____  Other Youth Memberships                  _____  _____________________

 

 

 

Work Experience (List dates, place, and type of work) (up to 5 points)

_____  Currently employed  ___________________________________________________________________

_____  Other experience  _____________________________________________________________________

 

Current Awards, Certificates, and Achievements (up to 2 points each)

_____  CPR Certification                          Year  ________________

_____  First Aid Certification                   Year  ________________

_____  Life Guard Certification                Year  ________________

_____  Other Current Awards and Achievements

 

Discretionary Points Awarded by the Hurley Lions Scholarship Committee (up to 5 points)

_____  For participation in Lions Club Activities, Outstanding Community Service, Outstanding Community                             Leadership, etc.)

_____  Other volunteer service

 

** Tie score of all points shall be broken by a 2-page hand-written essay (submitted blind – no name attached) judged by the Hurley Lions Scholarship Committee, which shall grade on spelling, form, content, and penmanship.

__  Explain how awarding this scholarship to you will promote the Objectives of Lions International (see above)

_____  Describe what you have already done to promote the Object of Lions International (e.g. community service activities, community involvement, etc.)

_____   Please hand write your essay legibly, print or script, and limit it to two pages.

 

WHAT YOU ARE TO DO:

Complete and submit this application, at least one letter of reference, most recent transcript, typed resume and handwritten essay with the above information, and send to the Scholarship Committee, Hurley Lions Club, PO Box  261, Hurley, NY 12443, by no later than April 25, 2023.