Key Club Scholarship Application

Serving the Children of Richmond

Please be ready to submit the application and email the supporting documents soon after to: Kiwanis Key Club Committee, c/o James E. Ryan, Jr., 5305 Tuckahoe Ave., Richmond, VA. 23226. Or email to: jameseryan@verizon.net. To be considered for this scholarship, ALL OF THE REQUESTED INFORMATION MUST BE RECEIVED BY FRIDAY, APRIL 26, 2024.

Applicant Name (Applicant must be a graduating senior who will be continuing his/her education in the Fall 2024)

First Name

Last Name

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

High School Attending

High School Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

High School Phone

(###)

###

####

Who is the Key Club Advisor at your high school?

First Name

Last Name

PART 1: PARTICIPATION IN KEY CLUB ACTIVITIES

A. (Years/Months)

B. Please name Key Club activities in which you have been a participant or an attendee:

Please name extracurricular activities in which you have been a participant (e.g. school activities and organizations, prizes, honors, offices, etc.):

PART II: ACADEMIC PERFORMANCE

What is your cumulative Grade Point Average (GPA)? Please forward a copy of your high school transcript to jameseryan@verizon.net supporting the GPA listed above.

PART III: POST-SECONDARY INSTITUTION ADMISSION

Please name the colleges or post-secondary institutions to which you have applied for admission:

Please name the colleges or post-secdonary institutions which have accepted you for admission:

Have you been offered scholarship assistance that prevents you from accepting the Kiwanis scholarship?

PART IV: ESSAY AND LETTERS OF RECOMMENDATION

Along with the information requested in this application form, please provide the following items: A written essay: "The Impact of Key Club Participation on Me" (1-2 pages, typed double-spaced) andTwo written letters of recommendation concerning the applicant's academic performance and potential; one of which MUST be from the Key Club's Faculty Advisor.

I certify that all information submitted in this application form, and all other information submitted as part of the application process for consideration of this scholarship is true, accurate, and complete to the best of my knowledge and belief.

Parent/Guardian

Key Club Faculty Advisor

Date

YYYY

Serving the Children of Richmond,
and the World

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Serving the Children of Richmond, and the World

Serving the Children of Richmond,
and the World