V.

List any other scholarships you have been awarded, are being considered for, or intend to
apply for, and their monetary value(s). Please indicate if you have been notified of an award and
its amount or your current standing in a competition.

Name of scholarship Amount or range Date of notification

or awarding organization of awards(s) of award

______
______
__________________________________________________________________

______
______
__________________________________________________________________

I am aware that the Kiwanis Club of Cary Education Trust Scholarships are intended to provide
financial assistance toward further education. If I am awarded other scholarships, which provide
the equivalent of full tuition, room, and board, I will not accept a monetary award from the Trust,
but may, at my discretion, compete for non-monetary honors.

Signature Date
I. Employment History (starting with current employer and working backwards, if applicable).
Baby-sitting, lawn work, etc. may be listed as a single entry. Employment also includes
volunteer work (for example, Candy Striper, Habitat for Humanity, missions, etc..):

Dates: From __________________ To __________________ Avg. hours per week: _________

Employer:
Address:
Supervisor:
Description of work:

Dates: From __________________ To __________________ Avg. hours per week: _________

Employer:
Address:
Supervisor:
Description of work:

PLEASE USE ANOTHER SHEET TO ANSWER THE QUESTIONS IN SECTIONS II,

III, AND IV.

II. Activities:
(a) List your extra-curricular activities (school, community, church, etc.) including
awards, honors, and leadership positions.

(b) Indicate how you spend your time outside of school (in hours per week such as work,
recreation, hobbies, clubs, family, friends, etc.)

(c) Describe, in detail, your participation in up to four of the activities listed in (a) above.

III. Discuss your reason(s) for applying for this scholarship and why it is important to you to
receive this scholarship.

Do you have any special responsibilities that you wish to share with us?

IV. Career Plans:

(a) What type of career interests you most? Why would you choose this career?

(b) What do you feel is required to prepare you for your vocational goals?
 2010 SCHOLARSHIP APPLICATION FORM
Kiwanis Club of Cary, NC
Educational Trust

Instructions: Applicants should either print or type the information requested on this form.
Incomplete applications may be disqualified. Information should be provided on additional
pages where noted. Read and sign the statement at the end of the application. Return this
application, along with a transcript for grades 9 through 12, postmarked by February 5, 2010.
Send it to: Cary Kiwanis Educational Trust, P.O. BOX 173, Cary, NC 27512-0173.

Name:
(last) (first) (middle)

Address:: __________________
(street) (city) (state & zip)

Parents’ Names & Address(if different from above)____________________________________

Phone # ________________________E-Mail ____________________________________

Other Family Members:

Graduating from (High School):

Character References: (please obtain permission for us to contact them):

Teacher

Address:

Neighbor:

Address: