St. Simons Island Rotary Foundation

 Scholarship Application


1.   Completed application form.

2.   Official high school transcript including any college credits.

3.   Official SAT and/or ACT scores.

4.   Two reference letters (not related to applicant).

5.   Autobiography of 500 words or less.

6.   Photograph

Incomplete applications will not be reviewed by the Scholarship Committee.

After the committee reviews the applications, they will select those to continue onto the interview process.  You will be informed if you are to be interviewed as well as the time and place.

Confidentiality Notice

Information contained in this document is for the use of the St. Simons Island Rotary Club Scholarship Selection Committee and will not be released to any other individual (s) without consent of the applicant. 

You will aid the Scholarship Committee in its selection process by giving us as much specific information as possible.  Unique circumstances may be deserving of unique awards, thus please make the committee aware of any special or unusual needs pertaining to your education.  

Application Deadline March 1


  Full Name:      Nick Name:   
  Street Address:   City,State,ZIP:    
  Phones :Cell:     Home: Email Address:    
  Age:   Year of High School Graduation:   
  High School(s):Attended    Dates Attended:   
  Dual Enrolement ?      
  Class Rank:   out of  College Planning to Attend:   
  Plans After College:     
  Parents/  Guardian Name(s):   Parents' Marital Status:   
  Children in Family (name, age):    
  Father's Occupation:   Father's Education:    
  Mother's Occupation::       Mother's Education:   
  Family Income:      


  Are your parents receiving any outside assistance ?
  If yes, explain:
  Will you be receiving a Grant, Scholarlship or Award for College ?
  If yes, explain:
  Approximate amount saved for college ? 
  Other sources to pay for college:
  Additional information regarding financial need:


  School Honors and Awards:
  School Organizations/ Clubs and Offices held:
  Activities/ Organizations outside school:
  Work experience/ Hours per week:
  Additional Information: