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RotaryClubofColonialParkFounda5on
PetonakFamilyActofKindnessScholarship
Name
RotaryClubofColonialParkFounda6on(“Founda6on”)ActofKindnessAward(“award”).
Purposeandwhoiseligible
Theawardshallprovidefinancialassistancetoahighschoolseniorstudentwhodesiresageneralcollegedegree.
ThestudentmustcurrentlyaGendCentralDauphinEastHighSchoolorCentralDauphinH i g h School.The source
of funds for this scholarshipisfromtheRotaryClubofColonialParkFounda6on.TheFounda6onwillreceivethis
dona6onannuallyandwillthenberesponsiblefordistribu6onandfollow-uptoaqualifiedcandidate. Thestudent
mustshowproofofacceptanceintoadegreeprogrambeforethescholarshipwillbeissued.
Amount
Theamountoftheawardforanacademicyearcanbeupto$1,000aRerallotherawardsandgrantsare received,
including tui6on andbooks. There canbe one awardofferedeachyearbut the totalamount shallnot be more
thantheamountreceivedannuallybytheFounda6onfromthedonor.
TermsofAward
The student must have served two or more full years as a volunteer in the mul6ple disabili6es classroom to be
consideredforthisscholarship.Thestudentmustbeaccepted into a c o l l e g e program before the scholarship
shall be awarded. The student may be a recipient ofanotherscholarship.Theawardmaynotbegivenforan
addi6onalacademicyear.
Upon comple6on of each college semester the student must send a transcript of their mid-term g r a des to
the Founda6on. The recipient shall submit the invoice from the school they are aGending or will aGend for the
semestertotheFounda6onfordirectpaymenttotheschoolwhenreceived.Fundswillbeissuedonasemester
basisfor anamountuptofivehundred($500)fortui6onandfees,(orlessifthesemestercostsareless)atthe
beginningofeach semester payable to the academic ins6tu6on in the student’s name. If any funds remain aRer
payment of tui6on and fees, the student may be reimbursed for textbooks upon submission of proper
documenta6on. The total award for tui6on, fees and textbooks will not exceed $500 per semester. At the
comple6on of the first semester the student may apply for another award up to five hundred ($500) for the
nextsemesterifallrequirementsaremet.
TheFounda6onwillreviewallapplica6onspriortothebeginningofeachschoolyearandpriortothestartofthe
followingsemester.Timelineswillbegiventothestudentreceivingtheawardwithdatesapplica6onsaredue for
thenextsemester.
Scholarshipsshallnotbeawardedtoanymemberorimmediatefamilymemberorrela6veoftheRotaryClubof
ColonialParkortheRotaryClubofColonialParkFounda6on.
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Criteria
Thestudentmustservetwo(2)ormorefullyearsasavolunteerinthemul6pledisabili6esclassroom.
Thestudentmustincludea500(fivehundred)wordessaywiththeapplica6onexplainingwhatthestudentgained
fromvolunteeringinthemul6pledisabili6esclassroomandhowithasaffectedthem.
ApplicationProcess
Students shall apply viahard copy or onthe Rotary Club of Colonial Park website www.colonialparkrotaryclub.org
andcompletethe applica6on that can be found under the tab “CP Rotary Founda6on,” then clickon
“scholarship” for “Act of Kindness.” Each applica6on form shall be completed by the studentand shall also
include the following: (1) an official current transcript of the student’s grades (2) a leGer of recommenda6on
from the student’s guidance counselor: (3) an essay of 500 words explaining what the student gained from
volunteering in the mul6ple disabili6es classroom and how it has affected them. The student may be asked to
meet with the scholarship commiGee for a personal interview and will be informed of the mee6ng 6me and
loca6on.
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ScholarshipApplica5on
FullName
HomeAddress
HomePhone
MobilePhone
EmailAddress
HighSchool
_________
SchoolandCommunityac5vi5es–useaddi5onalpaperifnecessary
1.
Listyourcommunityandschoolserviceac5vi5esandyears
2.
Listyourextra-curricularac5vi5esandyears
3.
Listanyhonorsorawardsyouhavereceivedforschoolwork,athle5cs,communityprojects,church,etc.
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Listcollegesinorderofpreferencetowhichyouhaveapplied.Indicateifyouhavebeenaccepted.
1.
AcceptedYes
No_____
2.
AcceptedYes
No_____
3.
AcceptedYes
No_____
Whatwillbeyourmajorincollege?_______________________________
ApplicationDates
Applica6onalongwithalldocumenta6onforthe“award”willbeduenolaterthanApril14,2017. Applica6onsfor
thisscholarshipcanbefoundontheRotaryClubofColonialParkwebsitewww.colonialparkrotaryclub.org under
theCPRotaryFounda6ontab. Applica6onsforthesecondsemesterwillbeannouncedeachyearontheRotary
ClubofColonialParkwebsiteaslistedabove.
SelectionCommittee
ThecommiGeeshallconsistofamaximumofthree(3)individualsfromtheRotaryClubofColonialPark
Founda6onboard.
Requirements
ThestudentwhoreceivesthisawardisalsorequiredtoaGendthepresenta6onoftheawardatamee6ngof the
Rotary Club of Colonial Park. Also, any other mee6ng of the Rotary Club of Colonial Park requiring the student
aGendance willbe given to the student at the beginning of each semester. Each student willbe asked to share
withtheclubwhatthisawardhasmeanttothemandprovideanupdateeachsemesterofthestudent’s ac6vi6es
andstatusinwri6ng.
SubmissionofApplica5on
Pleaseforwardyour2017applica6oninhardcopyorviatheRotaryClubofColonialParkwebsitebeforeApril14,
2017 to: Rotary Club of Colonial Park Founda6on, Act of Kindness Applica6on, 5901 Jonestown Road, POBox
126213,Harrisburg,PA17112–Scholarshipapplica6onspostmarkedaRerApril14,2017willnotbeconsidered.
Thescholarshipapplica6oncanalsobefoundonthewebsiteoftheRotaryClubofColonialPark
www.colonialparkrotaryclub.orgClickontheCPRotaryFounda4ontab
ChecklistofitemstobesubmiQedwithapplica5on
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Scholarshipapplica6on
Copyofhighschooltranscript
AleGerofrecommenda6onfromthestudent’sguidancecounselor
Alistofotherawardsthestudenthasappliedfor
Anessayof500wordsexplainingwhatthestudentgainedfromvolunteeringinthemul6pledisabili6es
classroomandhowithasaffectedthem
College/syouhaveappliedtoandwhichonesyouhavebeenacceptedtoasofdateofthisapplica6on
BrieflyaddressanyofthefollowingONLYifitappliestoyou:
o Ifyouhaveovercomepersonalhardshiporbarriersthatimpactedyoureduca6onalpathway
o Ifyourintentistopursuemorethanonemajor,pleaseprovideanintellectualorcareer
jus6fica6onforthedouble-degree
NOSTAPLESARETOBEATTACHEDTOTHISAPPLICATION
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ROTARY FOUNDATION/FINAL ACT OF KINDNESS SCHOLARSHIP APPLICATION WORD 2017 101716