2023 Online Arell College Scholarship Application (Independent Student Status)

Two and Four Year College Applicants

Eligibility Criteria

Applicant must meet one of the following criteria:

Be enrolled or be a recent graduate of a high school in Concord or Penacook. NH This includes Concord High School, Merrimack Valley High School, Bishop Brady High School, Concord Christian Academy, Parker Academy, St. Paul’s School, or Trinity Christian School.
OR, Applicant must be a current resident of Concord or Penacook, NH.
AND
Applicant must be entering or attending a two or four year college.
Applicant must demonstrate financial need.
Applicant may be a full-time or part-time student.
Applicant may be a home-schooled student.
Applicant may be a first-year or returning student.
Applicant may re-apply for additional scholarships in subsequent years.
Immediate family members of Rotary Club of Concord are not eligible.

Instructions for Two and Four Year College Applicants

Applications must be fully completed and include all required materials.
The Application period is from March 1 to May 2, 2022.
Applications must be received no later than May 2, 2022.
All questions must be answered in the fields provided in the form below.
No Supplemental pages or materials will be accepted.

A completed Application includes:

The Rotary College Scholarship Application completed and submitted below.
Your Official High School or College Transcript.
Score Reports of your SAT (optional), ACT (optional), and/or TOEFL, if applicable.
A Letter of Recommendation from a high school or college teacher or counselor.
A readable copy of your FAFSA Student Aid Report page which includes your EFC (Expected Family Contribution) amount.

Please complete the online form below. There is an option at the bottom of the form to save the application and return to complete it at a later time. When you have determined that your application is thoroughly complete, please click the Submit button.

BASIC INFORMATION

Full legal name *

Date of birth *

Gender *

Female
Male
Other

Country of citizenship *

Email *

Cell phone *

Home phone *

Mailing address *

Address Line 1

Address Line 2

City

State

Zip Code

High School or College you are attending (Name, City, State) *

Graduation date (month & year) *

College you will attend (Name, City, State) *

Start date *

College year you will attend in 2022/2023 *

Fr.
Soph.
Jr.
Sr.

Graduation year *

DOCUMENT CHECKLIST/UPLOADS

A high school transcript or college transcript (Only PDF and DOCX file types allowed) *

Click or drag a file to this area to upload.

A letter of recommendation from a teacher, professor, counselor, or employer (Only PDF and DOCX file types allowed) *

Click or drag a file to this area to upload.

A readable copy of your FAFSA Student Aid Report page which includes your EFC (Expected Family Contribution) amount. *

Click or drag a file to this area to upload.

The following file types are allowed: pdf; docx; jpg; png; bmp.

PERSONAL STATEMENT

Describe your career goals and your educational pathway to get there: *

Describe any relevant personal and/or family circumstances relevant to this request for financial assistance: *

ACTIVITIES AND WORK

List any school, club, or community experiences to help us better understand you and your application for financial assistance:

Activity 1

Describe your participation

Participation dates

Activity 2

Describe your participation

Participation dates

Activity 3

Describe your participation

Participation dates

List any work or work-based (job shadow, internship) experiences to help us better understand you and your application for financial assistance:

Employer 1

Position held

Participation dates

Employer 2

Position held

Participation dates

Employer 3

Position held

Participation dates

STUDENT STATUS: Independent

Spouse's name (if applicable)

Spouse's occupation (if applicable)

Number of dependent children *

Total number of family members *

Total number of family members attending college (including you) in 2022/2023 *

FINANCIALS

Please complete this section based on your (and your spouse's [if applicable]) most recent taxable year.

APPROXIMATE INCOME

Income earned by you - from IRS Form 1040 line 11 *

Income earned by your spouse (if applicable) - from IRS Form 1040 line 11 *

Other income (please enter dollar amount and explain source of other income) *

TOTAL INCOME *

APPROXIMATE ANNUAL EDUCATION-RELATED COSTS

Tuition and fees *

Room and board (if staying on campus) *

Commuter miles at approximate IRS rate (Daily round trip miles x $.56 per mile x number of days) if off-campus *

Book costs *

Technology, lab, health insurance costs (enter costs and explain) *

Enter any other costs and explain *

TOTAL COSTS *

APPROXIMATE EDUCATIONAL FUNDING PLAN

Amount you and/or your spouse can pay *

College work-study offered to you (if applicable)

Federal grants

College grants

Loans

Other amount (including VA Benefits) - please explain amount

TOTAL FUNDING RESOURCES *

TOTAL UNFUNDED COSTS (TOTAL COSTS minus TOTAL FUNDING RESOURCES) *

FAFSA and EFC *

I have submitted my FAFSA
I have attached my Student Aid Report and EFC

How did you hear about the Concord Rotary Club's Scholarship Program? *

SIGNATURE FIELD BELOW: Please use your mouse (if on a desktop/laptop) or your finger (if on a phone or tablet) to write your name in the field below. Keyboard entries are not accepted.

Applicant signature *

Date *

After submitting your Workforce application, you will receive an email confirmation that displays all your application entries. Please save and/or print that email for your records.

Save and Resume Application Later