School:

Waco Sunrise Rotary Club Scholarship Application

1. Applicant 2. Home Address

(Last)

(First)

(# & Street or Box)

3. Date Of Birth

School Year

(Middle) (City, State, Zip)

Phone

4. High School Presently Attending 5. List your participation in any of the following activities during the last two years: Community Activities

School Activities

Part Time Work

6. Describe Your Career Goals

Family Information 7. Name and Address of Parents or Guardian (Address)

(City, State, Zip)

(Phone)

8. Parent Occupations Father Mother 9. Siblings

Name

Age

10. Indicate the adjusted gross income for your family. <$25,000

$36,000 to $45,000

$56,000 to $75,000

$25,000 to $35,000

$46,000 to $55,000

$>75,000

Academic Information 11. Class Rank

Class Size

Diploma Plan

Regular

SAT/ACT Score

SAT

Most Recent GPA Recommended

Distinguished

ACT

Counselor verification signature 12. List colleges or universities where you have made an application

Accepted? Y/N

Applications must be complete for consideration. Include 3 letters of recommendation, 2 must be from school personnel (teacher, counselor or principal). Completed forms should be returned to the High School Counselors Office.