PANAMA CITY KIWANIS CLUB COMMUNITY SERVICE SCHOLARSHIP (FOR KEY CLUB MEMBERS ONLY) (CLASS YEAR - _______ ) $500 APPLICATION

DATE _____________________

NAME ____________________________________________________________________ ADDRESS _________________________________________________________________ __________________________________________________________________________ PHONE NUMBER ___________________________________________________________ HIGH SCHOOL _____________________________________________________________ PARENTS NAME ___________________________________________________________ DATE OF BIRTH ______________________________

Female[ ]

Male[ ]

The Panama City Kiwanis Club Community Service Scholarship is based solely on “community service” and has nothing to do with G.P.A., class rank, college or university selection, course of study, work experience, S.G.A. activity, athletic involvement, or family financial status. Your community service activity can be in conjunction with Key Club activities or other service clubs, but the hours of involvement must be verified by an appropriate official. Turn all completed forms in to your Key Club faculty advisor. Deadline each year is April 15th. Applications submitted after the deadline will be disqualified from judging with no further followup. No application materials will be returned. Do not submit photographs of yourself with the application. This scholarship requires a minimum of 100 community service hours the last 12 months before being awarded. Details will be made available to scholarship winners. Awards will be made during Senior Recognition Day.

EXAMPLES OF QUALIFYING HOURS

 Canvas local business for food for the elderly or indigent (can food drives)  Youth counselor in summer camp (allow 10 hrs/day max. times total no. of days @ camp, not 24 hrs/day with kids)  Make fruit baskets for delivering to elderly @ Christmas  Work with Habitat-for-Humanity or similar groups  Organize or work blood drives  Work C.P.C. Rescue Mission, American Cancer Society, Heart Association, United Cerebral Palsy, M.K. Lewis Center, etc.  Drug free council work (DARE)  Nursing home visits  Special Olympics  Youth baseball coaching  Kiwanis Pancake Days  Work on any Kiwanis I.D.D. Program  School clean-up days  Christmas gift wrapping  Retirement Center Breakfast (server)  Virtually anything associated with elderly or elementary school youth  Humane Society Work  Church work (explain)

EXAMPLES OF NON-QUALIFYING HOURS

 Organize Jr - Sr Prom  Attend school board meetings  Any activity you get paid to do  Student-faculty ball  Any sports event that doesn’t result in proceeds going to a needy cause (for indigent kids, elderly, human society efforts)  Project graduation  School advisory board meetings  School grant writing  School homecoming activities

LIST ANY VOLUNTEER AWARDS OR RECOGNITION YOU HAVE RECEIVED

EXAMPLES:  Youth volunteer of the year award (voted by school board or other official)  NASSP Award (National Association of Secondary School Principals)

FRESHMAN YEAR DATE OF ACTIVITY

ACTIVITY TITLE

BRIEF DESCRIPTION OF WORK PERFORMANCE

WHO CAN VERIFY HOURS WORKED

NAME / PHONE NO.

ACTIVITY HOURS

TOTAL HOURS __________________

Applicants Certification: These hours accurately reflect community service hours I spent during my Freshman Year. _______________________________ Signature Date:____________________

SOPHOMORE YEAR DATE OF ACTIVITY

ACTIVITY TITLE

BRIEF DESCRIPTION OF WORK PERFORMANCE

WHO CAN VERIFY HOURS WORKED

NAME / PHONE NO.

ACTIVITY HOURS

TOTAL HOURS __________________

Applicants Certification: These hours accurately reflect community service hours I spent during my Sophomore Year. _______________________________ Signature Date:____________________

JUNIOR YEAR DATE OF ACTIVITY

ACTIVITY TITLE

BRIEF DESCRIPTION OF WORK PERFORMANCE

WHO CAN VERIFY HOURS WORKED

NAME / PHONE NO.

ACTIVITY HOURS

TOTAL HOURS __________________

Applicants Certification: These hours accurately reflect community service hours I spent during my Junior Year _______________________________ Signature Date:____________________

SENIOR YEAR DATE OF ACTIVITY

ACTIVITY TITLE

BRIEF DESCRIPTION OF WORK PERFORMANCE

WHO CAN VERIFY HOURS WORKED

NAME / PHONE NO.

ACTIVITY HOURS

TOTAL HOURS __________________

Applicants Certification: These hours accurately reflect community service hours I spent during my Senior Year. _______________________________ Signature Date:____________________