Form | Ute Pass Kiwanis

Application Criteria & Instructions

You must be a graduating senior living in Teller County.
Scholarships will be awarded to students attending a 2 or 4 -year accredited college or university, vocational school, or certification program.
Your cumulative Grade Point Average (GPA) should be at least 3.0 on the current 4.0 scale. You must demonstrate intellectual promise and academic achievement.
You must demonstrate a potential for leadership and useful citizenship. Examples of this would include extra-curricular activities, community volunteer work and leadership roles within your community such as Key Club. Scholarships are awarded upon exceptional fulfillment of the above criteria, not necessarily upon financial need or GPA.

*NOTE: Students of exceptional or unusual qualifications who do not fulfill the above criteria are still encouraged to apply.

Please attach a letter of explanation of the exceptional circumstances.

Documents required for the application to be accepted:

Complete application – Part A
1 personal reference – Part B
1 extracurricular/ reference – Part C
Counselor sheet – Part D
Transcript – Part E
Personal Motto/Mantra or Impact Statement – Part F

The deadline is March 31, 2024

Applications will be evaluated by the Kiwanis Scholarship Committee.

Selections of scholarship winners will be announced prior to the close of the school year.

Winners will be invited to a UPWP Kiwanis breakfast ceremony to accept their scholarship award.

All monetary awards will be paid directly to the college, university, or vocational school on behalf of the student.

Scholarship Application Form

Part A

First Name

Date of Birth

Phone

Last Name

Email Address

Permanent Address

High School of Graduation

Anticipated Areas of Study (1-2)

List 3 Schools You Are Applying to & Amount of Scholarship Applied For/Received

Which Schools Have Accepted You

School & community activities in which you have been an ACTIVE participant & position you held in each. Name & phone number of person who can attest to your participation/role.

List special recognitions received at school or in the community and what you did to receive the recognition

List 1-2 organization(s) you were a part of that you felt most impacted you personally & how? How did your actions impact the community?

What primary resources/sources do you plan to utilize to fund your education? (Such as parents, loan, job, other scholarships, etc.)

The primary purpose of the UPWP Kiwanis club is to improve the quality of life for the children and families in Teller County. Write an essay on how you will use your education after college graduation to implement the mission and vision of Kiwanis to help your community. (Please attach a second sheet if needed).

If you are applying under “exceptional or unusual circumstances,” explain how and why you should receive a scholarship even though you do not meet one or more of the evaluation criteria. If this doesn’t apply to you, please put “N/A” in the lines below.

Required Document Attachments

Part B

Personal Reference Letter

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Please provide one personal reference letter to be completed by a non-relative, who knows you
well and can advocate for you for this scholarship.

Part C

Extracurricular Reference Letter

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Please provide one extracurricular reference letter to be completed by a non-relative, who knows
you well and can advocate for you for this scholarship. This should be someone who can attest to
your community work, your leadership skills and/or advocacy work at your school, in the
community or in a club, etc..

Part D

Counselor Sheet

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To be completed by the school counselor or a faculty member and must include:

1. Your name

2. Counselor's name

3. Office Phone number

4. Student's High School start date

5. Student's projected graduation date

Part E

Transcript

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Attach your High School transcript.

Part F

Personal Motto

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Personal Motto/Mantra or Impact Statement

By my signature below, I understand that if I am granted a scholarship, I will maintain a satisfactory academic standing while in college/university/certification program and conduct myself in a creditable manner. Lastly, I affirm that the information in this application is accurate and true.

Type Your Name as Signature

Thanks for submitting!