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Accepting the Challenge of Excellence Award

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The Exchange Club of Gilroy is offering
$00,000
in scholarships to the Class of 2024!

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APPLICATION FORM

 Complete the application below used by the high school in accepting scholarship applications from students.

On a separate piece of paper and prior to filling out the form,
please think about the essay.  You have between 800 – 1200 words to write about this subject.

THEME FOR SCHOOL YEAR 2022-2023

“Many people have
someone whom they admire, whether a parent, sibling, friend,
teacher, mentor, etc. Share a story about someone who has greatly
impacted your own life and the lives of others. Reflect on the
qualities and actions of this person and explain why they have
impacted you and your future.”

GRADE POINT AVERAGE

Please send your transcript of the records:

for ____________________________________ high schools: 3.0 or better

for __________________ high schools, ________________________________: 2.5 or better

CITIZENSHIP

Satisfactory

ATTENDANCE

Satisfactory

All of the above must be met to be considered for the scholarship.

FOR ANY QUESTIONS, PLEASE CONTACT:

DEADLINE FOR SUBMITTAL IS FEBRUARY 20, 2023

SEND US A QUESTION

ACADEMIC SCHOLARSHIP APPLICATION

Your Email Address(Required)

Enter Email

Confirm Email

Your High School(Required) HiddenSchool Year

Counselor Information

Counselor Name(Required)

First

Last

Counselor Phone Number

Counselor Email(Required)

Enter Email

Confirm Email

Student Information:

Name(Required)

First

Middle

Last

Address(Required)

Street Address

Address Line 2

City
AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
State

ZIP Code

Cell Phone(Required)Parents or Guardian Phone(Required)

Gender(Required)

Female

Male

Financial Information:

Briefly describe your family’s economic background. Include information about your financial challenges. Please include Number of people living in your household and any financial challenges: (attach additional sheet if needed)Briefly describe your family’s economic background. Include information about your financial challenges.

Please include Number of people living in your household and any financial challenges: (attach additional sheet if needed)

College and Career Objectives:

SECTION 1A – ACTIVITIES(Required)List the activities that your involved in:

Student Government – Report on highest office held per group each semester.
Newspaper/Annual School Publication – Report on highest position held per publication each semester.

Musical Organization – Band, Choir, Orchestra, Drum Major/Majorette.

Debate Activities – \”Winner\” denotes any recognized award achieved as an individual, or as a member of a team, in either an inter-or-intra-school competition. Only one victory may be counted per semester. \”Team\” denotes any group representing either a high school class or the high school as a whole. You will receive a score as a winner and as part of a team.

Stage Production – \”Performer\” Denotes active partification on stage as a member of a theatrical or similar school sponsored production. \”Production Crew\” denotes partifiation in a activity necessary to support a school performance (i.e) stage-hand, projectionist, makeup, etc.) Only one performance may be counted per semester

Athletic Teams – Captain or Co-Captain, Team Member, List no more than 2 per semester. Do not include intramural sports.

Club Membership – Club authorized and sponsored by the high school) Officer, Member, list no more then 2 per semester.
SECTION 1B – COMMUNITY SERVICE ACTIVITIES(Required)List the activities that your involved in:

Community Organization Membership
Including youth groups, religious, and service organizations which meet at least once a month). Let us know if you held the Position of President, Officer, Member. List no more than 2 per semester and no more than 20 hours per semester.
List the activities that your involved in: Volunteer Service HoursHow many hours have you worked as a volunteer?
Examples include hospital or nursing home service, Salvation Army Bell-ringing, etc.) List no more than 2 per semester and no more than 20 hours per semester.(Required)List the activities that your involved in:

Volunteer Service Hours
How many hours have you worked as a volunteer?
Examples include hospital or nursing home service, Salvation Army Bell-ringing, etc.) List no more than 2 per semester and no more than 20 hours per semester.
SECTION 2 – GRADE POINT AVERAGE(Required)Grade point average is for semester perido beginning with sophomore (10th grade) year and ending with the close of the first semester of the senior (12th grade) year.Please enter a number from 0.00 to 4.0.SECTION 3 – PERSONAL/ACHIEVEMENTS/AWARDS(Required)List upto 10 Personal Achievements/Awards, specifying if local, state, or national. A
SECTION 4 – ESSAY: Between 800 – 1200 words(Required)THEME: “Many people have someone whom they admire, whether a parent, sibling, friend, teacher, mentor, etc. Share a story about someone who has greatly impacted your own life and the lives of others. Reflect on the qualities and actions of this person and explain why they have impacted you and your future.”

The essay must be between 800 – 1200 words.
SECTION 5 – NARRATIVE A(Required)Narrative A (not to exceed 250 words) – Describe in your own words the event or events in your life of which you are most proud of.
SECTION 6 – NARRATIVE B(Required)Narrative A (not to exceed 250 words) – Describe in your own words your plans
for the future to make your community and world a better place to live.
Do you have any additional comments?
Signature(Required)CommentsThis field is for validation purposes and should be left unchanged.