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Scholarship Application Form

PERSONAL DATA:

Name:

Last Name

First Name

(M.I.)

(Street Number and Name)

Address:

City

State

Zip Code

Telephone:

Email:

Select:

Female

Male

Social Security Number:

Date of Birth:

Name of Parents (or guardian):

(Street Number and Name)

Address:

City

State

Zip Code

Telephone:

Email:

Are you a Village Club Employee?

No

Yes

If yes, give Hire Date Employee Dept

If no, how are you related to The Village Club Employee?

HIGH SCHOOL DATA:

High School:

(Street Number and Name)

Address:

City

State

Zip Code

Name of school counselor:

Date of Graduation:

Cumulative Grade Point Average (4.0 scale):

SCHOOL ACTIVITIES:

List and describe school activities that you are or have been involved in during the past four (4) years (attach separate page, if necessary):

COMMUNITY ACTIVITIES:

List and describe community activities that you are or have been involved in during the past four (4) years (attach separate page, if necessary):

ATHLETIC ACTIVITIES:

List and describe athletic activities that you are or have been involved in and that are not described above (attach separate page, if necessary):

SCHOLARSHIPS, GRANTS, ETC.:

List and describe other scholarships, grants or tuition reimbursements you are receiving or have applied for (attach separate page, if necessary):

AWARDS AND HONORS:

List personal, local, state or national awards and honors you have received (attach separate page, if necessary):

COLLEGES, UNIVERSITIES AND/OR PROGRAMS:

List colleges, universities, and/or vocational training programs that you have applied to or been accepted to, along with the state or country where located (attach separate page, if necessary):

Separately, please include the following:

Resume indicating work experience
At least two (2) letters of recommendation by non-family members. Preference will be given to recommendations from faculty members or other individuals active in your education.
Official transcript of your high school scholastics
Essay describing your qualifications and need for this scholarship. You should include any special strengths, skills or financial need.

CERTIFICATION
I certify that all the statements made in this application are true, complete, and correct.

Applicant’s Signature:

Date:

(For applicants under 18 years of age)

Parent/Guardian Signature:

CHECKLIST

Completed Scholarship Application signed by Applicant, Parent/Guardian (high school students)
Original transcript from high school (high school students)
Original transcript from college/graduate degree program
Resume indication work experience
At least two (2) letters of recommendation by non-family members.
Essay, no more than 750 words in length
Photograph (optional)

APPLICATION SUBMISSION

Send Application, Official Transcript(s), Letters of Recommendation, Essay and optional photo in one envelope to:

The Village Club Enrichment Fund (Scholarship Application)
190 East Long Lake
Bloomfield Hills, MI 48304
Questions: (248) 644-3450

PLEASE HELP US RECOGNIZE YOU AND YOUR CONNECTION TO THE VILLAGE CLUB BY ATTACHING A PHOTO [OPTIONAL] TO THIS APPLICATION. THANK YOU.

APPLICATION DEADLINE: May 1, 2022

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