HS Scholarship Application

- Step 1 of 4

Please Read Important Information Prior to Completing Application

1. The completed Kiwanis Club of Roanoke scholarship application, together with all required attachments, is due by March 13, 2026.

2. All information will be regarded as confidential.

3. The application is to be completed by the applicant.

4. Scholarship award checks will be distributed directly to the college/university attended by the scholarship winners.

5. A copy of the submitted application will be emailed to the applicant.

Name of Applicant *

First

Last

Address *

Address Line 1

City

State

Zip Code

Email *

Confirm Email

Phone *

Name of High school *

Only applications from students at the following High Schools will be considered: Cave Spring, Hidden Valley, Northside, Patrick Henry, Roanoke Catholic, William Fleming.

Parents' Names *

Occupation of Father *

Please be specific about occupation; list employer name and job title. Do not merely state "self-employed" or "manager" or "supervisor."

Occupation of Mother *

Please be specific about occupation; list employer name and job title. Do not merely state "self-employed" or "manager" or "supervisor."

Which Parent Will Assist You Paying For College *

Father
Mother
Both
Other

If only one parent is covering college expenses and is filing a separate tax return, please indicate which parent below and select only his/her income. If both parents are covering college expenses, select total income of both parents.

If "Other," Explain

Parents Taxable Income (please ask parent to select one) *

Under $50,000
$50,000 to $100,000
$100,000 to $150,000
over $150,000

According to most recent filed federal tax return, line 15 from IRS Form 1040. Ask your parent to select one.

Student Aid Index *

Student Aid Index (SAI) from the Free Application for Federal Student Aid (FAFSA).

Describe Any Unusual Family Financial Obligations For Parent(s)

Number of Brothers and Sisters *

Number of Brothers and Sisters in College During Upcoming Year *

List of Names of Colleges Where You Have Applied *

Agreement Career Year

List of Names of Colleges Where You Have Been Accepted *

Total First Year College Expenses $ *

Including tuition, fees, books, on-campus housing and meals.

Total Financial Resources Available for First Year $ *

Amount from Family $ *

Amount from Personal Savings $ *

Expected Earnings This Summer $ *

Scholarships/Grants $ *

List each scholarship or grant amount you have been approved for and name of college.

Loans $ *

List each loan amount and source.

Career Goals *

Explain your career goals as you know them at this time of your life. Two sentences maximum.

Community Service *

Throughout your high school career in what community service activities have you been involved?

Work *

What is your work experience during High School, if any? Please indicate the amount of time spent working.

Honors and Awards *

List honors and awards you have received.

School Activities *

List your participation in school activities noting any leadership positions held. Use full name of organizations. No acronyms, please.

Important Activities *

Explain, in up to three sentences each, your role in your two most important school/community service/work activities.

Why Do You Need This Scholarship? *

Any Additional Information You Would Like to Share (optional)

Upload Your School Academic Transcript *

Drag & Drop Files, Choose Files to Upload

Upload Two Letters of Recommendation *

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

Agreement *

I agree that all information in this application is accurate and complete.

Signature *

Clear Signature