SCHOLARSHIP APPLICATION – Seattle Hiroshima Club Website

Online Scholarship Application Form

The Seattle Hiroshima Club Scholarship Trust Fund will fund scholarships of $3,000 each, for one to three high school seniors for their higher education. The intent of this award is to honor and provide assistance to the descendants of currently active members of the Seattle Hiroshima Club.

Eligibility:

One of the student’s parents/guardians, grandparent(s), great-grandparent(s) or relative
must be from Hiroshima Prefecture.
The parent/guardian or applicant must be a current paid member of the Seattle Hiroshima
Club
The applicant is graduating from high school and the latest high school transcript reflects a
cumulative GPA of 3.5 or higher.

Application:
The completed application must be postmarked by Saturday, February 3, 2024.
The following documents must be submitted:

Completed application
Official high school transcript which includes marks from the 9th, 10th, and 11th grades.
List of current classes and projected second term courses.
Two letters of recommendation: one from a school staff member, and one from the larger community, such as an employer, church leader, etc.. (Recommendations from family members or relatives will not be accepted.)
An essay on “What Hiroshima Means to me” (Minimum of 200 words)
Paid membership in Seattle Hiroshima Club by applicant or applicant’s parent/guardian.

Selection Criteria:
The applicants will be rated and ranked on the following:

Academic achievement
School Recognition and Awards
Extracurricular school activities
Community involvement, activities and recognition
Recommendations and essay

First Name

Last Name

Address

Address (ie. Apt #)

City

State

Zipcode

Phone

Date of Birth

High School Name

Location

CUMULATIVE GRADE POINT AVERAGE (which includes 9th, 10th and 11th grade):

Name of Father

Name of Mother

SIBLINGS (Names and Ages)

HIROSHIMA LINEAGE: Name of Hiroshima immigrant related to you

Full name of parent with Hiroshima lineage

Prior or Current Member of SHC? (Y or N)

Yes No

Full name of grandparent with Hiroshima lineage

Prior or Current Member of SHC? (Y or N)

Yes No

Full name of great-grandparent with Hiroshima lineage

Prior or Current Member of SHC? (Y or N)

Yes No

Full name of great, great-grandparent with Hiroshima lineage

Prior or Current Member of SHC? (Y or N)

Yes No

SCHOOL AWARDS AND RECOGNITION:

EXTRACURRICULAR SCHOOL ACTIVITIES:

COMMUNITY INVOLVEMENT AND ACTIVITIES:

NON-SCHOOL AWARDS AND RECOGNITION:

HOBBIES AND INTERESTS:

EMPLOYMENT HISTORY (From grade 9 to date):

Name/Location of Employer

Dates of Employment

Name/Location of Employer

Dates of Employment

Name/Location of Employer

Dates of Employment

COLLEGES AND UNIVERSITIES APPLIED TO:

PROPOSED DEGREE/MAJOR:

FUTURE GOALS AND ASPIRATIONS:

THE FOLLOWING DOCUMENTS MUST ACCOMPANY THE APPLICATION:

1. Senior high school official transcript as of the latest completed semester/trimester.

2. List of current classes and projected second term courses.

3. An essay of 200 words on the subject “What Hiroshima Means to me”.

4. At least two recommendations: one from a school official, and one from a community member.
(Recommendations from relatives will not be accepted.)

UPLOAD FILES: