2023 Online Arell Workforce Scholarship Application (Dependent Student Status)

Eligibility Criteria

Applicant must meet one of the following criteria:

• Be enrolled (soon to graduate) or have graduated from 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.
• Have a verifiable residence in Concord or Penacook.
• Have fully completed a two-year CTE program at the Concord Regional Technical Center
• Immediate family members of Rotary Club of Concord are not eligible.

Applicant must be entering or attending one of the following:

• Professional licensure (EMT, Cosmetologist, Electrician, etc.)
• Industry valued certificate (American Welding Society, Amazon AWS, etc.)
• College certificate in a trade-based career (automotive technology, advanced manufacturing, etc.)
• College associate’s degree in a trade-based career (HVAC, Orthopedic Tech, etc.)

Instructions for Workforce Applicants

• There Is No Application Deadline for the Arell Workforce Scholarship. Workforce Applications are accepted throughout the year.
• Applications must be fully completed and include all required materials.
• 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 Workforce Scholarship Application completed and submitted below.
• A Letter of Recommendation from a high school or college teacher or counselor or employer.
• If you have attended a high school in Concord or Penacook within the past five years:
  • An Official transcript from a high school or a college if the applicant has completed at least six on-campus classes.
  • 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

  AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

  Zip Code

  High School attended (Name, City, State) *

  High School graduation date (month & year) *

  Work Program planning to attend (Name, City, State) *

  Certificate, License or Degree *

  Program start and end dates *

  
  

  DOCUMENT CHECKLIST/UPLOADS

  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.

  If you attended a high school in Concord or Penacook within the last five years, please upload a high school transcript, or college transcript if you have completed at least six on-campus classes already (Only PDF and DOCX file types allowed)

  Click or drag a file to this area to upload.

  (only if applicable) 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: Dependent

  Parent/Guardian 1 name

  Parent/Guardian 1 occupation

  Single, married, separated, divorced, or widowed

  Parent/Guardian 2 name (if applicable)

  Parent/Guardian 2 occupation

  Single, married, separated, divorced, or widowed

  Total number of family members *

  Total number of family members attending post-secondary at once (including you) *

  
  

  FINANCIALS

  Please complete the following section in cooperation with your parent/guardian(s) based on their most recent taxable year.

  APPROXIMATE INCOME

  Income earned by parents/guardians - from IRS Form 1040 line 11 *

  Income earned by you - 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 *

  Equipment/Tools costs (enter costs and explain) *

  Enter any other costs and explain *

  TOTAL COSTS *

  
  

  APPROXIMATE EDUCATIONAL FUNDING PLAN

  Amount you and/or your family can pay *

  College work-study offered to you (if applicable)

  Federal grants

  Loans

  Employer reimbursement

  Other amount (including VA Benefits) - please explain amount

  TOTAL FUNDING RESOURCES *

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

  
  

  FAFSA and EFC (if applicable) *

  • I have submitted a readable copy of my FAFSA Student Aid Report page which includes my EFC (Expected Family Contribution) amount
  • I do not have a EFC

  EFC Amount

  
  

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

  
  

  SIGNATURE FIELDS 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 *

  Clear Signature

  Date *

  Parent, Guardian or Spouse signature if under 18

  Clear 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.

  SubmitSave and Resume Application Later

  Saving your progress now will store a copy of your entry on this server. For security reasons, file uploads will have to be re-entered when you resume.

  Please click the Continue button to view and copy a link to use when you resume filling out your application or to receive the resume link via email.

  Continue Go Back

  Your entries to the Arell Workforce Scholarship Application have been saved and a unique link has been created which you can access to resume this form.

  Enter your email address to receive the link via email. Alternately, you can copy and save the link below.

  Please note, this link should not be shared and will expire in 30 days, afterwards your form entries will be deleted.

  Copy Link

  Email *

  Send Link