scholarships

Rim Country Optimist Club

2012 SCHOLARSHIP APPLICATION FORM

The Rim Country Optimist Club awards scholarships to graduating Payson High School Seniors. The scholarship is paid directly to an accredited college, university, or vocational school upon verification of enrollment. Scholarship recipients and the amounts will be announced by the May graduation. **

ALL APPLICATION MATERIALS MUST BE POST MARKED BY APRIL 30, 2012 TO THE FOLLOWING ADDRESS:

OPTIMIST SCHOLARSHIP COMMITTEE

P. O. Box 2273

PAYSON, AZ 85547

NAME ______________________________________________________________________________

LastFirstMiddle

ADDRESS ___________________________________________________________________________

CITY ___________________________ STATE ___________________ ZIP _______________

TELEPHONE _____________________ CELL _____________________

LAST SCHOOL ATTENDED_______________________________

NAME AND ADDRESS OF COLLEGE, UNIVERSITY, OR VOCATIONAL SCHOOL WILL YOU BE ATTENDING?

____________________________________________________________________________________________________

Academic Achievements and/or Extra Curricular Activities (Awards, Honors, etc.)

_____________________________________________________________________________________________________

Employment History (Employer, Job Title, Duties, Dates of Employment, Supervisor’s Name)

_____________________________________________________________________________________________________

Community Service (including volunteer work in behalf of community, service or religious organizations or activities)

_____________________________________________________________________________________________________

The following ATTACHMENTS are required to complete this application:

A. Academic Transcripts: Please provide one official transcript for each school in which you have completed high school credit.

B. Essay Question: Please provide essays (500 words maximum) responding to the following questions:

1.Excluding parents, relatives & close friends, whom do you most admire and why?

2.What goals and plans do you have following post-secondary education? What do you hope to

accomplish five years later?

3.What are your plans for obtaining the rest of the financial support needed to complete your

education?

C. Three (3) Letters of Reference. No more than one of these references may come from Payson Unified School District professionals or personnel. Adults should provide all references, and none should come from parents, siblings or other relatives. References not conforming to these specifications will be excluded.

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

Student Signature _______________________________________ Date _________________________

Parent/Guardian Signature ___________________________________ Date ___________________

Date & Time of Receipt ____________________________ Received by _____________________________________

**Recipients must provide name, address, phone number, and student ID# of the post-secondary institution selected for enrollment. Remember your award will be paid directly to the institution; submit your enrollment verification receipt as soon as possible. If you have any questions about this application process please contact Bonnie Young, Treasurer, 928-478-6969.