High School Community Service Scholarship Guidance Counselor GPA Certification Form

GLENS FALLS ROTARY CLUB
PO Box 4702
Queensbury, NY 12804

COMMUNITY SERVICE SCHOLARSHIP APPLICATION
SPRING 2010
Guidance Counselor GPA Certification Form

APPLICANT’S NAME:  ___________________________________     
 
APPLICANT’S HIGH SCHOOL: _________________________     

GUIDANCE COUNSELOR:  _______________________________ _  

Phone Number: _________________

E-mail Address: _________________

TO: The Rotary Community Service Scholarship Selection Committee

I hereby certify that this applicant for The Glens Falls Rotary Club’s Community Service Scholarship has attained least a “B” average and meets this eligibility requirement to be considered for the scholarship.

_____________________________ _______________________________
(Signature)     (Print Name)

_____________________________
(Date)