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Application for High School Students

The Union City Rotary Club is pleased to provide an online scholarship application for your convenience. Users are required to use their existing SOCIAL SECURITY NUMBER and create a PASSWORD. Should you need to stop the application process before it is complete, you may SAVE your application, logout and login at a later date to finish it at your convenience. Simply enter your unique SOCIAL SECURITY NUMBER and PASSWORD to open your application.

You must enter your Social Security Number and password each year to submit your Rotary application. All previous year applications and passwords are removed from the site to protect the studentís information.

The password needs to be at least 5 alpha or numeric characters. These fields are not case sensitive.

Thank you and e-mail us with any questions. info@unioncityrotary.org

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If you created an account in previous years, please create a new login to submit your application for the current year.

Current Users

Please enter your login credentials below.

Social Security Number: - -
Password:
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New Users

Please create your login credentials below.

Social Security Number: - -
E-mail:
Password:
Confirm Password:
 

Before you proceed, please read the following…

Union City Rotary Club Scholarship Award Process

Scholarships from the Union City Rotary Club are awarded primarily on the basis of financial need; however, there are a very limited number of scholarships based on scholastic achievement and/or study in a particular field.

The scholarship committee always considers financial need first and the students are ranked according to this need; then, the committee must give consideration to the student's interview and third, any special requirements of the donor's scholarship are considered to determine the final award selection.

Our scholarship committee is made up completely of volunteers who spend many hours reviewing the scholarship application data and then interviewing each high school student to determine who is awarded a scholarship and the amount of the scholarship. These decisions are not taken lightly and are made as objectively as possible, but when presented with over 350 scholarship applications and all the variables involved, it is impossible to complete the process without a certain amount of subjectivity being used in making these awards. The Union City Rotary Club and the donors to the scholarship program would like to award a scholarship to every applicant to the program, but unfortunately, our funds are limited and we are not able to make awards to every applicant. We hope all of you can appreciate the complexity of our task and respect the decisions made by the committee.

Your best chance of success in receiving a Rotary Scholarship is to completely fill out the Scholarship Application and provide all supporting documentation. If you or your family has any unusual situations that affect your ability to pay for your college education, be sure to note this in the appropriate section of the application because these factors are always considered by the committee.

Please complete the information to follow to the best of your ability.

All fields with an * are REQUIRED

Do you have Children?* Yes No
If so, ages:

INTRODUCTION:

Will you be attending: College Vocational School Other

PERSONAL INFORMATION:

First Name:* Middle Name:
Last Name:* Address:*
City:* State:
Zip Code:* E-mail:*
Primary Phone: Secondary Phone:
Age:* I live with:*
Father's Name: Address:
City: State:
Zip Code:    
Mother's Name: Address:
City: State:
Zip Code:    
High School:*
If you are not in high school, you must complete the college application.
GPA (4.0 scale):*
You must enter Either SAT score, ACT score, or both to complete this section:*
ACT Score: SAT Score:
Rank in graduating class: out of:
Institution Name planning to attend: Location:
Major: Attendance:* Full time
Part time
Number of hours you will have after the spring semester:    
Does your family use electricity from Union City Electric System:* Yes No
Is any member of your family a Rotarian?* Yes No
If yes, name of member and your relationship to the Rotarian:    
Are you a member of the National Wild Turkey Federation?* Yes No    
What is your membership number if member?*    

Note: Children, grandchildren and spouses of children or grandchildren of Rotary members are eligible for a Verhine Estate Rotary Funded Scholarship.

EXTRACURRICULAR ACTIVITIES: Required for High School Senior Applicants Only

List the number of years you were a member of the following clubs and organizations. List any offices held.

 

CLUB YEARS OFFICES HELD
Beta Club
National Honor Society
Writer's Club
Spanish Club
French Club
Foreign Language Club
Girls or Boys State
Challenge Program
Christian Youth Club
FFA
Fellowship of Christian Athletes
Other Religious Club
DECA
VICA
Who's Who
Band
Art Club
Senior Superlative
Annual Staff
School Newspaper Staff
Pep Club
Junior Civitan
FCCLA
Leadership Obion County
Chamber Youth Community Service
HOSA
Honor Student
Key Club
Christian Student Association (CSA)
Computer Club
FTA
Photography Club
SADD
Skills USA
Sock & Buskin Club (drama)
Warriors of the Ink (writing)
Academic Decathlon
Other 1
Other 2
Other 3
Freshman Class Officer: President Vice-President Secretary Treasurer No
Sophomore Class Officer: President Vice-President Secretary Treasurer No
Junior Class Officer: President Vice-President Secretary Treasurer No
Senior Class Officer: President Vice-President Secretary Treasurer No
Student Government Officer: President Vice-President Secretary Treasurer No
Academic Top Ten:
Freshman Year Yes No Sophomore Year Yes No
Junior Year Yes No Senior Year Yes No
Other honors and awards:
Most significant community and volunteer activities:
Religious activities:
Vocational achievements, activities and awards:
How many, if any college credits have you earned?
What are these college credit courses?

List number of years participated and awards:

EVENT YEARS AWARDS
Basketball (boys')
Basketball (girls')
Football
Soccer (boys')
Soccer (girls')
Baseball
Cross Country
Track
Golf
Softball
Cheerleading
Tennis
OTHER YEARS AWARDS
Academic Decathlon (AcaDec)
Band (Marching)
Band (Jazz)
Flag Corp
Show Choir
Student Government Association
Rebel Beat News
OCCHS Yearbook

FINANCIAL NEEDS:

A. The Student Aid Report – SAR you receive from completing the Free Application for Federal Student Aid MUST be attached in digital form. Form 1040 Federal Income Tax Returns are no longer accepted for Financial Need verification. If you wish to only be considered for a Merit scholarship, please attach a letter to that effect below in the “Additional Uploads” section.

Attach a copy of your Student Aid Report (SAR) *.
File must be in a PDF, JPG, Doc or Docx format.

Attach File:

The Union City Rotary Scholarship Committee relies heavily on the EFC (estimated family contribution) calculation when making our scholarship decisions that is provided by Free Application for Federal Student Aid (FAFSA). To find out more on how to obtain an EFC number, please visit www.fafsa.ed.gov or ask your guidance counselor.

What is the Expected Family Contribution (EFC) and why do we need it?
The Expected Family Contribution (EFC) measures your family's financial strength, and is used to determine your eligibility for federal student aid during one school year. Your EFC will be displayed on your Student Aid Report (SAR) after your FAFSA is processed.

The information you reported on your Free Application for Federal Student Aid (FAFSA) is used to calculate your EFC. The school uses the EFC to determine your federal student aid eligibility and financial aid award.

Your EFC is not the amount that your family will have to pay for college nor is it the amount of federal student aid that you will receive. It is a number used by the school to calculate the amount that your family will be expected to pay for college and the amount of federal student aid you are eligible to receive.

The Union City Rotary Club Scholarship Committee uses the EFC as a measure of your financial need. The majority of our scholarships are awarded on the basis of financial need and it is critical we have a good measure of this need. If the SAR report with your indicated EFC is not provided it could negatively affect your chances for receiving an award from the Rotary Club.

B. Please enter your Expected Family Contribution (EFC) from the Student Aid Report (SAR):*
Numerics only.

C. Who is responsible for funding your education?

Self
Both Parents
Father
Mother
Self and Parents
Step-parent / Guardian
Grandparent
Other
Father's occupation:
Mother's occupation:
Father's employer:

Mother's employer:
Father's gross income:

Mother's gross income:
Step-parent / Guardian's Occupation:
Step-parent / Guardian's employer:
Step-parent / Guardian's gross income:
 
Your Occupation:
Spouse's Occupation:
Your Employer:
Spouse's Employer:
Your Gross Income:
Spouse's Gross Income:


If less than 26 years of age, please list the number of children in your family including yourself:


Ages:
Other dependents: (e.g. elderly or disabled relative)
Number of children in college or vocational school (excluding yourself):
Name of school(s) they attend:
Is your brother/sister receiving any financial assistance for school? Yes No
Name of scholarship or type of aid (if known).
Amount of scholarship or type of aid (if known).
Do you have your own transportation? Yes No
Who makes monthly payments?
Do you help pay for the gas and/or insurance? Yes No
Year Make: Model:
Please explain any unusual circumstances (illness of parent, unemployed parent, divorced, unusually high cost of education such as medical school).


Are you employed? Yes No
Employer: Hours worked per week:
How long have you been employed with this company?
List a history of your work experience:


How much will your education cost next year?
Other school if not listed above:
(Use only numbers when entering dollar amounts)

Tuition / Fees: Books: Food: Other:
Housing: Transportation: Miscellaneous:


How much will you or your family contribute:
Parent's contribution: Your contribution:
Other contributions:  


How much do you expect to receive in other grants, scholarships, Tennessee State Lottery Scholarship, etc.? Please itemize.
A. B.
C. D.

Have you applied for a student loan? Yes No
If yes, then how much:

Are you planning on working while in school? Yes No
Number of hours:


What other information do we need to know about your situation that has not been covered by the information filled out on the application?

Describe your dream and how are you going to pursue that dream. Please limit to 200 words in the text box below.
Scholarship recipients are requested to attend the Union City Rotary Club Scholarship Banquet where they will meet with their benefactors on the second Friday of May at 12:00 Noon. The banquet will be held at the First Baptist Church – Family Life Center located at 500 East Church Street in Union City. Recipients are encouraged to write their benefactors a thank you note, send them a Christmas card, and drop them an occasional note telling them how you are doing. The scholarship committee has found it is much easier to ask a benefactor for another scholarship if their past recipient has shown these courtesies.

NOTE: Rotary Scholarship money can only be used for tuition, fees, books and on-campus room and board.

Rotary Scholarship money is to be used only after all other scholarships and grants are used. Scholarships must be used within one year or they will be forfeited unless approved by the Scholarship Committee due to special circumstances.

Research Rotary International at www.rotary.org or Union City Rotary Club www.unioncityrotary.org

Additional Uploads (Please attach any supporting documents you think relevant to your application):
Attach File:

Attach File:

Attach File:

Attach File:

Due Date: April 15th

I certify that the information in this application is correct to the best of my knowledge.


Applicant*

School Counselor
(MM/DD/YYYY)
Date Submitted*



Signature (for printed copy only)

Please note that the winners of the Rotary Scholarships will be posted on the Rotary website on the Monday prior to the Friday scholarship banquet. The Verhine Scholarship recipient banquet will be held the first Friday in June at the Hampton Inn in Union City at noon. The information can be found on http://www.unioncityrotary.org/rotaryScholarships/index.asp.

Please be sure to click the SUBMIT button once you are finished with entering your data. You will then see a page that thanks you for applying and will soon receive an e-mail confirming the receipt of your application by the Rotary Scholarship Committee (provided you gave us an e-mail address). If you do not see the “thank you” page, then your application was not submitted.

      


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