Optimist Club of Hernando ScholarshipScholarship Application Printable PDF Last(Required)First(Required)MiddleAddress(Required) Street Address City State / Province / Region ZIP / Postal Code Email(Required) Date of Birth(Required) MM slash DD slash YYYY Name of High School(Required)Date of Graduation(Required) MM slash DD slash YYYY ACT Score(Required)Once the form is submitted you will be emailed a PDF. You must print the form and have your school's counselor the form Certifying your ACT scores and GPA LIST ANY OFFICES HELD BY YOU, AWARDS RECEIVED, MEMBERSHIP IN ANY CLUBS(use separate sheet, if needed)What institution of higher learning do you plan to attend and what is your major area of educational interest?Please list below extracurricular activities, community services activities and any volunteer work.Please list each member of your household and their relationship to you.Please give the approximate amount of your family’s total household income.Please list any scholarships, grants or other types of financial aid that you have received or for which you have applied and been granted.Why should you receive this scholarship?Are you or have you been a member of a Junior Optimist Club or Octagon Club? Yes No (if so when and where)Are your parents a member of the Optimist Club or have they ever been a member? Yes No (if so, when and where)Scan and email your letters of recommendation and endorsement to [email protected] from any two of the following: 1. High School Teacher who has taught you in class. 2. High School Sponsor or Coach of an extracurricular activity 3. An adult who is not a member of your familyThe application, signed by your high school counselor and letters of recommendation must be returned to Optimist Club of Hernando no later than April 29 of the year you are applying for.Humanity Check(Required)What is 3 plus three ?NameThis field is for validation purposes and should be left unchanged.
