Virginia M. Wagner Educational Grant Application
Application is Due JANUARY 15th by 11:59pm
  • APPLICANT DATA

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  • FAMILY MAKE-UP

  • HIGH SCHOOL DATA

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  • POST-SECONDARY SCHOOL DATA

    Name of post-Secondary school in which you are enrolled. Use official school names, please do not abbreviate.
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  • ESSAY

    Attach a typewritten essay, limited to two pages, covering the following topics.

    1. Why did you choose to enter this profession?

    2. What is your ultimate goal in this profession?

    3. How would this grant affect your educational plans?

    4. What efforts have you and your family made toward obtaining your degree?

    5. What unusual family or personal circumstances have affected your achievement in school, work experience, or your participation in school and community activities?
  • TRANSCRIPTS

    An official transcript of grades for the past academic year must be sent with this application. Jpeg and PDF files are acceptable.
  • ACTIVITIES, OFFICES, HONORS, AWARDS

    List all community or school activities in which you have participated without pay during the past four years (e.g. work at school or children’s school, civic or cultural organizations). Note special awards,
  • WORK EXPERIENCE

    Describe your work experience during the past four years (if homemaker, please indicate). Indicate dates of employment for each job and approximate number of hours worked each week. List monthly amounts earned.
  • Employer/Position From Mo/Yr To Mo/Yr Hours Per Week Earned Weekly
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  • FINANCIAL

    To be considered for the grant, this information must be filled out completely.
  • Books
    Room & Board
    Tuition
    Other (Specify)
  • OTHER FINANCIAL AID

    Please list the name and annual amount of any grants or scholorships you have been awarded for the school year
  • Name of Award School where award will be used Award Amount Granted Pending
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  • REFERENCES

    Please list three references (not relatives), one of whom is a professor at the school you attend. Please attach letters of reference.
  • Name Occupation Address/Zip Code Phone Number
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  • SIGNATURES

    • I certify that all information provided in this application is complete and accurate to the best of my knowledge. I will notify the designated club to which I have submitted this application if there are any changes.

    • I understand that this award is not a scholarship and is therefore taxable for citizens of the United States. (For more information, consult IRS publication 520.)

    • I certify that this is the only application I have made this year for a Virginia M. Wagner Grant or for a Live Your Dream Award from this or any other Soroptimist club.

    • I understand that my application becomes the property of Soroptimist International of the Americas, Midwestern Region. The application will be considered confidential unless the applicant grants Soroptimist written permission to release personal information for the purpose of publicizing the Soroptimist Virginia M. Wagner Grant. By typing or signing your name below, you adhere to the above requirements.
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