Rotary Scholarship 2015 Guidance Counselor Certification Form
Download The Form Here
GLENS FALLS ROTARY CLUB
COMMUNITY SERVICE SCHOLARSHIP GUIDANCE COUNSELOR CERTIFICATION FORM
STUDENT APPLICANT’S NAME: ____________________________________________________
APPLICANT’S HIGH SCHOOL: ______________________________________________________
GUIDANCE COUNSELOR: _________________________________________________________
Guidance Counselor’s phone number: ______________________________________________
Guidance Counselor’s e-mail address: ______________________________________________
The section below is to be completed only by the student’s Guidance Counselor. Once signed by the Guidance Counselor, the Certification Form should be forwarded via e-mail to:
David Kisselback (Chairman, Glens Falls Rotary Scholarship Committee)
TO: Rotary Scholarship Committee
I hereby certify that the applicant named above has attained at least a “B” average and therefore meets this academic requirement to be considered for the 2015 Glens Falls Rotary Club Community Service Scholarship.
(Print Guidance Counselor Name)
(Guidance Counselor Signature)
Children and Grandchildren of Rotarians are NOT eligible to apply for this scholarship.