Glens Falls Rotary - Box 4702, Queensbury, NY 12804

Club President
David Bogue
David Bogue
Rotary International
District 7190

Print this page

Rotary Scholarship 2015 Application Form

Download the Application Form Here


Community Service Scholarship Application

Spring 2015



NAME:   __________________________________________  HIGH SCHOOL _______________________


Address: _____________________________________________________________________________


Home Phone #: __________________  Cell Phone #: __________________ E-mail __________________


This completed application (typed in Word or other word processing software), and the additional documentation described at the bottom of this form, must be e-mailed by April 24, 2015.



ESSAY questions: 

  • Please write a short essay describing your community service activities, and explain how your involvement or leadership role exemplifies the Rotary motto, “Service Above Self.”  Feel free to attach a separate sheet, or you may write in the space below:





  • Please tell us about your post- high school graduation plans.






The following additional documentation must also be submitted by the deadline:

  1. 1.        A brief letter of support from the leader of an organization which benefited from your service, describing the impact of your involvement. 


  1. 2.       The Guidance Counselor Certification Form signed by your Guidance Counselor confirming that you meet the minimum required “B” average.  Please DO NOT provide your high school transcript and DO NOT provide copies of your Counselor’s college Letter of Recommendation.


Please forward this completed application and required additional documentation (via e-mail) to: David Kisselback at   Please email any questions to the same address.  Thank you.




Children and grandchildren of Rotarians are NOT eligible to apply for this scholarship.






Meeting Time & Location Information
Thursday at 12:15 PM
The Ramada
1 Abbey Lane
Queensbury, NY 12804  map it
Contact Information
David Bogue
phone: 518-321-9922
fax: 518 409-8436
contact us

**The Club also meets at 7:30 AM for breakfast every 1st and 3rd Tuesdays each month at the Ramada Inn, Exit 19, Rt. 87, ADK Northway. For info call 855-499-0001.


Site Content and Photographs ©2015  Glens Falls Rotary.  All rights reserved.

Website application developed and hosted by RUSHweb Solutions.