Please fill out and submit the application below by midnight on Wednesday, January 31, 2024.

District 5220 Scholar Application 2024
Are you a member of a Rotary Club, or have you been a member within the past 3 years?
Has a parent or guardian been a member of any Rotary Club within the past 3 years?

Note: A “Yes” answer to either question above makes you ineligible for this Rotary Scholarship

Personal Information

Gender
Address
Address
City
State/Province
Zip/Postal
Country

Language Skills

List all the languages you speak, including your native language.
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Emergency Contact Info

Emergency Contact: Address
Emergency Contact: Address
City
State/Province
Zip/Postal
Country

Prior Education

List the two educational institutions you have most recently attended.

Summary and Objectives

Rotary Areas of Focus

What is your Rotary Area of Focus?

Scholarship Information

Provide the following information about the academic program you plan to attend.

Budget

Detail all of your proposed expenses by providing us with numbers beyond the stated scholarship award amount of US$15,000 to give us a complete picture of your financial need. If selected, these funds are potentially eligible for a match of US$15,000 from The Rotary Foundation, if criteria for a Global Scholar are met (only if the successful candidate will be studying internationally). Attach any documents, such as price sheets, bids or estimates, to support the expenses listed. Note: The selected candidate will work with D5520 Rotarians to develop a full budget, determine appropriate and ineligible expenses, and a payment/reimbursement plan for the scholarship funds.

Additional Expenses

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Financing

The scholarship amount is US$15,000 from District 5220. You are personally responsible for all expenses in excess of the US$15,000 scholarship amount. Please list and describe your sources and sufficiency of additional funds that will cover the balance of your budget – be sure to let us know the status and amounts you expect to receive in the form of scholarships, grants, stipends, research assistantships, teaching assistantships as well as the expected amounts of your loans, financial aid, private funding, etc.

Maximum file size: 67.11MB

If you have any questions about submitting this application online or if you would prefer to fill out a writeable PDF document, please contact our Rotary District Scholarship Chair Julie O’Kane via email at okane@sbcglobal.net.