Application for Memorial Educational Assistance Award

Optimist Club of Centerville noon logo. On the outside is a blue ring and in light yellow letters it says on the top "Optimist International" and on the bottom it says "Optimist Club of Centerville - Noon." On the inside of the blue ring is a yellow circle that has the Optimist International logo; a gold "O" around a gold "I"

Centerville Noon Optimists

Memorial Educational Assistance Award Application

$2,500.00

(Renewable for a second year at $2,500.00)

Qualifications:

  1. Be a graduating high school senior that will be attending a college/university offering a two/four year degree upon completion of an accredited program.
  2. Be a resident of Centerville/Washington Township.
  3. Have a strong record of participation in community service activities.
  4. Possess a financial need.

Please provide as much information as possible. The only information the selection committee will have to judge your eligibility for the Centerville Noon Optimist Educational Assistance Award will be the information you provide. If the space provided on this Application is not sufficient to provide the information requested, you may include additional information.

As well as completing the application below, you will need to upload your FAFSA Student Aid Index and a narrative to be limited to one page, double spaced, on the topic: Why is it important that community members provide service to youth, and what is the high school student’s role in providing such service?

This application becomes the property of the selection committee and will not be returned to the applicant.

The selection committee will inform all applicants of their decision before May 1.

Applications will not be considered if not received by April 1.

Questions
600 Memorial Educational Assistance Award Application 2043.07.18

Application for Award

First
Last
Address
Address
City
State/Province
Zip/Postal
Number of students in your graduating class.
Father’s Name
Father's Name
First
Last
Mother’s Name
Mother's Name
First
Last

Siblings

Name
Name
First
Last
College?
Currently attending college?
plus Add Sibling minus Remove Sibling

Extracurricular Activities

List extracurricular activities, noting: (1) the hours involved in each activity per week; (2) the length of time involved in the activity; and (3) any leadership positions or accomplishments while participating. You may either enter the information below or upload a document with the information.

Maximum file size: 10MB

Will accept .pdf, .doc, .docm, .docx but prefer .pdf

Community Service Activities

List community service organizations (whether related to school, church, or other organization), noting: (1) the hours involved in each activity per week; (2) the length of time involved in the activity; (3) the way, if any, in which each organization serves the youth of our community; and (4) any leadership positions or accomplishments while participating. You may either enter the information below or upload a document with the information.

Maximum file size: 10MB

Will accept .pdf, .doc, .docm, .docx but prefer .pdf

Employment History

Please provide employment history including dates worked for each employer.
Address
Address
City
State/Province
Zip/Postal
plus Add Employer minus Remove Employer

References

Please provide the name and address of three references: (1) a teacher, counselor or administrator at your school; (2) a person outside your immediate family who knows of your community service; and (3) anyone outside your family.

School:

Please provide your relationship to the reference (teacher, counselor, advisor, employer, coach, etc.)
Address
Address
City
State/Province
Zip/Postal

Community:

Please provide your relationship to the reference (teacher, counselor, advisor, employer, coach, etc.)
Address
Address
City
State/Province
Zip/Postal

Other:

Please provide your relationship to the reference (teacher, counselor, advisor, employer, coach, etc.)

 

Address
Address
City
State/Province
Zip/Postal

College Plans

In order of preference, list colleges or schools to which you have applied, noting the status of your application (accepted or pending) and the estimated annual cost (tuition, room and board).
Status
$
plus Add College minus Remove College

Financial Need

$
$

Maximum file size: 10MB

Will accept .pdf, .doc, .docm, .docx. but prefer .pdf

Maximum file size: 10MB

Will accept .pdf, .doc, .docm, .docx. but prefer .pdf

Other

I certify that the above information is true to the best of my ability and I authorize the selection committee of the Centerville Noon Optimists to contact the references listed above and any teacher, counselor or administrator at my school relative to determining my eligibility for a Centerville Noon Optimist Educational Assistance Award.

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