SCHOLARSHIP PURPOSE: The Rotary Club of Belleville recognizes and rewards local students who embody the high standards of the Rotary International motto, "Service above Self." Students may apply for a $5,000 academic, vocational, or community service scholarship.

STUDENT: Students need to complete the application below by providing the requested information. Award recipients must reside in Belleville, Sumpter Township, or Van Buren Township or attend Van Buren Public Schools, and plan on attending an accredited vocational school, community college, or university.

DEADLINE FOR SUBMISSION: April 7, 2025

Student Information

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Phone *

Email Address *

Which scholarship are you applying for? (Choose one). *

Academic

Vocational

Goals

Which colleges and Universities have you applied to? Which have you been accepted to? *

What do you want to study in college and why? *

Where do you see yourself in ten years as it relates to your chosen field of study? *

Please submit an essay (maximum 1,000 words) describing how this scholarship will assist you with your educational and career goals. *

Academic Records

High School *

City *

State *

GPA *

Please list all academic achievements, awards, and/or extracurricular activities during the last four years. Include honors and advanced placement classes, student government, band, sports, clubs, and other school projects. Also include hobbies or other personal interests. *

Community Service Activities

Please list and describe any community service activities including school, church, scouting and/or community volunteer activities. Also indicate any awards or honors you have received relevant to community service activities. *

Which community service project are you most proud of any why? *

Since you are applying for a Rotary Club scholarship, what do you know about the Rotary Club (https://www.bellevillerotary.org/)? *

How would you be an ambassador for Rotary at the local level (https://www.rotary.org/en/rotary-ambassadors)? *

Rotaract (stands for "Rotary in Action") Clubs bring together people ages 18 and older to exchange ideas with leaders in the community, develop leadership and professional skills, and have fun through service. Frequently, Rotaract Clubs can be found on college campuses (https://www.rotary.org/en/get-involved/rotaract-clubs). Do you plan to be involved with a Rotaract Club if it was offered on your campus? *

Yes

Employment Information

Are you currently working? *

Yes

Have you worked at a paid position in the past? *

Yes

Please list your employment history, including company names, dates of work, etc. *

Letters of Recommendation

Upload a first letter of recommendation *

Upload a second letter of recommendation *

Upload a third letter of recommendation (optional)

Upload a fourth letter of recommendation (optional)

Other Information

Is there any other relevant information that you would like the scholarship committee to know? Please explain.

 Do you anticipate that your school financial aid need may not be met? If so, please explain:

What do you like to do when you are not studying? *

What is something you are passionate about? Please explain in about 100 words. *

If you won a million dollars, what would you do with the money? *

Family Information

Please list the number of family members at home *

Please list any family members attending colleges/universities and the institution(s) they attend *

To confirm residence eligibility, please list your parents' or guardians' name(s) and address(s) *

Please list your parents' or guardians' occupations and employers *

Permissions and Acknowledgements

I certify that the information presented in this application is true and that I meet all of the following qualifications:
-I either reside in Belleville, Van Buren Township, or Sumpter Township, OR attend school within one of those three areas
-I am a graduating senior
-I am planning to attend an accredited vocational school, community college, college, or university in the coming academic year
-If applying for an academic scholarship, I have a minimum GPA of 3.0
-I have demonstrated involvement in school activities
-I have demonstrated significant involvement in community service activities

Please select one option: *

Yes, I meet all of the requirements

No, I do NOT meet all of the requirements

You have selected that you do not meet all of the scholarship qualifications. Please explain why you selected that option.

I give my current school permission to release my transcripts or other information as required by the Rotary Club of Belleville. *

Yes

Please sign *

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