Kiwanis of Homestead-South Dade

Online Scholarship Application – Student Portion

All applications are due by March 31, 2024. Incomplete applications will not be considered.

Please fill out form in full below. If there are any questions, please contact Mia DeVane at miadevane2@yahoo.com. Once form is filled out in full and submitted please use this link to have your school administration complete their portion.

Administrator/Faculty Advisor Application Page

Name *

First

Last

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Date *

High School *

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Age *

M/F *

Male
Female

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

2nd Phone

Email *

Head of Household (Parent or Guardian):

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Name *

First

Last

Age *

Occupation *

Family Members (Please list names and relationship)

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Family Member 1 Name

Family Member 2 Name

Family Member 3 Name

Family Member 4 Name

Family Member 5 Name

Family Member 6 Name

Family Member 1 Relationship

Family Member 2 Relationship

Family Member 3 Relationship

Family Member 4 Relationship

Family Member 5 Relationship

Family Member 6 Relationship

Please list names of any siblings attending attending college or vocational/tech school and the name of the institution.

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School to which you have been accepted to & plan to attend: *

Planned Field of Study (Major): *

Academic Achievements

Please list all academic accomplishments achieved during each year of high school.

International Baccalaureate Classes

Advance Placement Classes

Dual Enrollment Classes

Honor Classes

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Vocational/Tech Classes

Academic Awards

Please list all Academic Awards (i.e., Honor Rolls, Honor Societies), Designations (i.e. Cum Laude, Magna Cum Laude, Summa Cum Laude, Salutatorian, Valedictorian), Silver Knight nominee and any other awards. Spell out any acronyms.

Extracurricular Activities

Please list all extracurricular activities you participated in during each year of high school. Include the number of years you were active in each activity. Include Participation in: Athletic Activities, Music, Band, Dance, Student Government, Councils, Clubs, Scouts, Civic Club Participation (i.e. Key Club, Jr. Civitan, Interact, etc.)

Non-Academic Awards & Honors

List: Civic Awards, Sports Awards, Dance and Music Awards, Club Awards and other special recognitions.

Leadership

List positions of leadership held, include but not limited to any of the above activities. List your title as well as duties and responsibilities. This would include any positions as captain or co-captain, club offices, nonacademic awards.

Community Service

Please list all community service (include information including number of hours and a brief but complete description of your involvement).

Work Experience

Please list any work experience. Include after school jobs and any employment during summer or winter school breaks. Include a brief description of your duties and/or responsibilities.