Central Kentucky Alumni Club Scholarship Application

CENTRAL KENTUCKY ALUMNI CLUB

UNIVERSITY OF LOUISVILLE

SCHOLARSHIP APPLICATION

The Central Kentucky Alumni Club of the University of Louisville sponsors two types of scholarships to the Central

Kentucky graduating high school seniors planning to attend the University of Louisville:

A one-year full-tuition scholarship and possible partial tuition scholarships awarded to students best

exemplifying the following characteristics: leadership ability, academic achievement, breadth of interests

and financial need as determined by a committee of club members

A $1,000 Michael R. Baer tuition scholarship awarded preferentially to a student whose parent or guardian

is a recovering, current patient or victim of terminal illness.

To be eligible, you must:

Be a resident of Fayette, Jessamine, Woodford, Clark, Bourbon, Scott, Harrison or Madison county.

Have submitted an application for admission to the University of Louisville

Applications must be mailed by April 15 and you must include:

Official high school transcript

Two letters of recommendation, one of which must be from a teacher

Name ______________________________________________________ Date of Birth ______________

Address ____________________________________________________ Telephone ________________

City _____________________________________ Zip Code __________ Citizenship _______________

SS# ________________________ GPA ___________ SAT Math/Verbal ___________ ACT __________

Current School and Address _____________________________________________________________

____________________________________________________________ Class Rank ______ of ______

Counselor _______________________________________ Counselor's Telephone # ________________

Indicate which scholarship you are applying for: Club Scholarship ________ Michael R. Baer _________

Governor's Scholar: Yes ____ No ____

School and Community extra-curricular activities. Please include dates of participation and offices or leadership

positions held.

__________________________________________________________________________________________

Please list all honors and awards, including scholarships, that you have received.

__________________________________________________________________________________________

Why would this scholarship benefit you?

__________________________________________________________________________________________

Please list full or part-time employment experience including the company or organization by which you were

employed, dates and positions held:

__________________________________________________________________________________________

What do you consider to be your greatest achievement?

_________________________________________________________________________________________

__________________________________________________________________________________________

How do you plan to pay for the costs of your college tuition?

_________________________________________________________________________________________

__________________________________________________________________________________________

Michael R. Baer Scholarship applicants: In order to fully consider applicants who meet this criteria, please use the

space below to provide pertinent information.

__________________________________________________________________________________________

By my signature below, I attest to the accuracy of the statements on this application and hereby give my

permission to the Central Kentucky Alumni Club of the University of Louisville to verify all information and I agree

to the release of all my school transcripts, test scores, grades, and class rank.

Signature ____________________________________________________ Date ___________________

Please mail completed application and supporting material by April 15 to:

Paul W. Graf

3367 Ridgecane Road

Lexington, KY 40513

If you have any questions concerning the application, please contact Paul Graf at (home) 859-224-2609 or

(work) 859-232-3823.