Kiwanis Club of Thomasville

Scholarship Application 2021-2022

This application is for the purpose of selecting the recipient of a scholarship to be paid to the
recipient after receipt of acknowledgement of enrollment in a college, university, or technical
school. Only students who have maintained high moral and ethical conduct during high school
will be considered. The scholarship shall be awarded to graduating seniors on the basis of
demonstrated ability and desire. Applications must have an accumulative grade point average of
3.0 or more at the end of winter quarter of their senior year. The application must be returned to
the high school counselor by Friday, April 1, 2022.

Name: DOB:

Address:

Phone: Expected graduation date:

Parent(s) or Guardian(s):

Is anyone in your family a member of a Kiwanis Club?

If yes, please list which Kiwanis Club, the family member’s name, and his or her relation to you.

High School:
Name City State

College, university, or technical institute you plan to attend:

Have you been accepted for admission?

School Activities:

Leadership Positions and Activities:

School Clubs:

Scholastic and/or Sport Teams:

Community Activities:

Awards and Honors:

Hobbies and Leisure Activities:

Check list of items that must be submitted before scholarship application will be considered for
selection:

Completed Application Letter of teacher recommendation

High School Transcript Copy of acceptance letter from

college, university, or technical
institute

Please return completed application along with the additional requested documents
to your high school counselor by Friday, April 1, 2022.