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ROBERT N. STYRES SCHOLARSHIP OF THE ROTARY CLUB OF THE CAPITAL CITY Nomination Information Date NAME Last First Middle ADDRESS Street City TELEPHONE State Zip EMAIL HIGH SCHOOL GRADE POINT AVERAGE Please attach transcript. CAREER GOAL EXTRA-CURRICULAR ACTIVITIES OTHER COMMUNITY INVOLVEMENT FAMILY INFORMATION Confidential Gross Family Income Less than 25 000 25 000 to 50 000 Greater than 75 000 Number of Family Dependents WRITE A LETTER DETAILING YOUR DESIRE AND NEED FOR THIS SCHOLARSHIP. THIS LETTER AND A LETTER OF RECOMMENDATION WILL ACCOMPANY YOUR FORM AND TRANSCRIPT TO THE ROTARY CLUB IF YOU ARE SELECTED. You do not need to submit your letter of recommendation at this time. Just be prepared to provide one. CAREER GOAL EXTRA-CURRICULAR ACTIVITIES OTHER COMMUNITY INVOLVEMENT FAMILY INFORMATION Confidential Gross Family Income Less than 25 000 25 000 to 50 000 Greater than 75 000 Number of Family Dependents WRITE A LETTER DETAILING YOUR DESIRE AND NEED FOR THIS SCHOLARSHIP. THIS LETTER AND A LETTER OF RECOMMENDATION WILL ACCOMPANY YOUR FORM AND TRANSCRIPT TO THE ROTARY CLUB IF YOU ARE SELECTED. THIS LETTER AND A LETTER OF RECOMMENDATION WILL ACCOMPANY YOUR FORM AND TRANSCRIPT TO THE ROTARY CLUB IF YOU ARE SELECTED. You do not need to submit your letter of recommendation at this time. Just be prepared to provide one. CAREER GOAL EXTRA-CURRICULAR ACTIVITIES OTHER COMMUNITY INVOLVEMENT FAMILY INFORMATION Confidential Gross Family Income Less than 25 000 25 000 to 50 000 Greater than 75 000 Number of Family Dependents WRITE A LETTER DETAILING YOUR DESIRE AND NEED FOR THIS SCHOLARSHIP. THIS LETTER AND A LETTER OF RECOMMENDATION WILL ACCOMPANY YOUR FORM AND TRANSCRIPT TO THE ROTARY CLUB IF YOU ARE SELECTED. You do not need to submit your letter of recommendation at this time. Just be prepared to provide one..

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