2020 scholarship application rotary club of san …...school transcript, two teacher written letters...

5/6/2020 Rotary Club of San Jose East/Evergreen 2019 - 2020 Scholarship Application

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1. Email address *

Rotary Club of San Jose East/Evergreen 2019 -2020 Scholarship Application* Required



All scholarship applications must be submitted through this online form. However, before you beginthis process, it is advisable that you download the scholarship application worksheet from the San JoseEast Evergreen Rotary Club website (https://rotarysjee.org/) to ensure you have all the necessary dataready. In addition to the data on the worksheet, you will need to obtain a certified copy of our highschool transcript, two teacher written letters of recommendation, on your school letterhead, and thesigned and dated parental authorization form, also available on the San Jose East Evergreen RotaryClub website. All of these documents will need to be uploaded as PDF files and named using thefollowing naming convention: For your transcripts, the pdf should be named using your first and lastname proceeded by "transcript", (example Jerry Erich transcript.pdf). For the teacher recommendationletters, use your first and last name proceeded by 1 or 2 (example Jerry Erich 1.pdf and Jerry Erich2.pdf). For the permission form use your first and last name proceeded by "permission" (example JerryErich Permission.pdf). Failure to follow these directions may result in the rejection of yourapplication. If you are unfamiliar with PDF, a web search will show you many free tools out there toconvert documents to PDF.

Application deadline is midnight May 31st.No applications will be accepted after that time. So don't delay. Gather your information and submit your application today.

Gerald and Dorothy Erich Endowment Fund Scholarship Application

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First Name *

Last Name *

Address *



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1st Choice Community College or Trade School You Plan to Attend

City *

State *

Zip Code *

High School Name *

Cell Phone(xxx) xxx-xxxx

Home Phone(xxx) xxx-xxxx

Last 4 of your Social Security Number or Individual Taxpayer Identification Number *Required by school and/or college finance departments, If you don't have either just say DNHO (Don't HaveOne).



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2nd Choice Community College or Trade School You Plan to Attend

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1st Choice School Name *

1. Annual Tuition *

1. Room & Board *(if applicable)

1. Other Expenses *Books, Fees, Transportation, etc.

1. Total Cost *Add tuition, room & board and other expenses

1. What amount will you and/or your parents be able to pay? *

2. School Name



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3rd Choice Community College or Trade School You Plan to Attend

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2. Annual Tuition

2. Room & Board(if applicable)

2. Other ExpensesBooks, Fees, Transportation, etc.

2. Total CostAdd tuition, room & board and other expenses

2. What amount will you and/or your parents be able to pay?

3. School Name

3. Annual Tuition



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ParentalIncome

An important concern of the Scholarship Committee is to provide financial assistance to students who need it most. The following section will help our committee make its decision.

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3. Room & Board(if applicable)

3. Other ExpensesBooks, Fees, Transportation, etc.

3. Total CostAdd tuition, room & board and other expenses

3. What amount will you and/or your parents be able to pay?

How many people, including you, live in your household? *

How many family members are currently attending a college or trade school? *

List your first parents occupation *



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Check all that apply.

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List your second parents occupation *

Please mark the box which best represents your parents combined total annual income

Column 1

$0 - $19,999

$20,000 - 39,999

$40,000 - $59,999

$60,000 - $79,999

$80,000 - $99,999

$100,00 and above

$0 - $19,999

$20,000 - 39,999

$40,000 - $59,999

$60,000 - $79,999

$80,000 - $99,999

$100,00 and above

Please list any additional expenses or special circumstances which may limit your family'sability to assist you with your education.

As you make plans for your first year, how much money do you plan to contribute? *Consider your savings, what you will earn during the remainder of the school year, and what you plan to earnover the summer.



Your WorkHistory

Please list the five most recent jobs, full-time and part-time, that you have held during the past two years. To skip this section, scroll to the bottom and select next.

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Your Work History - Job 2To skip this section, scroll to the bottom and select next.

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1. Employercompany name

1. Your Job Title

1. Approximate Dates of Employment

1. Hours Worked per Week


2. Your Job Title



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3. Your Job Title






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Your Work History-Job 5To skip this section, scroll to the bottom and select next.

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Your Grades and Test Scores

4. Your Job Title




5. Your Job Title





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PSAT ScoreIf you have taken the PSAT Score, enter your results below

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If you have taken the SAT, enter those scores below.

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GPA *Enter you current high school accumulated GPA.

PSAT Composite Score

PSAT Verbal Score

PSAT Math Score

SAT Composite

SAT Verbal Score

SAT Math Score



If you have taken the ACT, enter that information below.

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List your participate in extracurricular and community activities below

YourActivitiesandSuccesses

List your participation in extracurricular and community activities. Include offices held, performances given, awards received, special events, major accomplishments, etc.

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ACT Composite Score

1. Activity DateFormat should be MM/DD/YYYY-MM/DD/YYYY or MM/DD/YY or MMM YYYY

1. Your AchievementDescribe what you did or achieved

2. Activity DateFormat should be MM/DD/YYYY-MM/DD/YYYY or MM/DD/YY or MM YYYY



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Upload Required DocumentsTo complete your application, you must upload the follow documents.




Use the space below to tell us about your career plans after you graduate from high school. *



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Files submitted:

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Files submitted:

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Files submitted:

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Files submitted:

End

This concludes the Gerald and Dorothy Erich Endowment Fund Scholarship Application. If you have any questions, you may direct them to:Erich Endowment Fund ScholarshipHarbinder Sikka, President of the [email protected](408) 834-6039

Good Luck!

Your Certified High School Transcript *You must upload your transcript as a single PDF file that is no larger than 1MB. Make sure to name the fileusing your first and last name proceeded by "transcript" (example jerry erich transcript.pdf).

Letter of Recommendation from Teacher 1 *The letter must be on school letterhead, must be submitted as a single PDF document, and may be no largerthan 1MB. Make sure to name the file using your first and last name proceeded by "1" (example jerry erich1.pdf).

Letter of Recommendation from Teacher 2 *The letter must be on school letterhead, must be submitted as a single PDF document, and may be no largerthan 1MB. Make sure to name the file using your first and last name proceeded by "2" (example jerry erich2.pdf).

Parental Authorization *You must have a parent complete the parental authorization form and upload it here. The file must be a PDFand no larger than 1MB. Make sure to name the file using your first and last name proceeded by"permission" (example Jerry Erich Permission.pdf)

mailto:[email protected]



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