Zonta Club of Cape Girardeau Scholarship Application Complete the form below, by September 1st. Or print this form and email to capezontaservice@gmail.com. Which Scholarship are you applying for today?(Required) SEMO Non-traditional Scholarship CTC Practical Nursing Scholarship Personal InformationName Email PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country EducationHigh School Education(Required)School AttendedYear of GraduationGPAPrevious Educational ExperiencesName of College(s), Address of School(s), Years Attended, Certificate/DegreeCurrent Educational Status Graduate Student Undergraduate Student Transfer Student Other Current GPAMajorMajorHours Completedas ofDegreeDegreeHours Presently Enrolled inHonors, Awards, and Extracurricular ActivitiesList your most important honors, awards, and extracurricular activities. Indicate offices held.One item per line, use the plus sign to add additional lines. Add RemoveFamily Income Information and Personal ResourcesFather / GuardianNameAddress of OccupationPrevious Years IncomeMother / GuardianNameAddress of OccupationPrevious Years IncomeSpouseNameAddress of OccupationPrevious Years IncomeSelfNameAddress of OccupationPrevious Years IncomeHow many people are dependent on the above income?Name and Ages of Children Are you currently working?Hours per week? Earnings per week? Current EmployerName of Business and Yearly Salary? What kind of vehicle do you own?Please indicate the year of the vehicle. Will there be any changes in the above information?Please explain in detailDescribe any other pertinent information concerning the financial assets and obligations of your family that would be helpful in assessing your financial need for the scholarship requested:Are you related to a member of the Zonta Club of Cape Girardeau?If yes, please explain Financial AidAre you currently receiving financial aid through the University or any other source?If yes, list the aid which you are receiving, the amount, and the award period. This includes Pell Grant, Veteran's Benefits, AFDC/TANF, Other Scholarships, or Unmet NeedPersonal EssayPlease provide a short statement explaining why you have chosen to continue your education at this point in your life and why you feel you should receive this scholarship.Essay shall be no less than 200 words and no more than 400 words.CertificationBy signing this application, I certify that the information provided is correct. I also give Student Financial Services at Southeast Missouri State University or Cape Career and Technology Center permission to forward my completed application and the results of my Free Application for Federal Student Aid (FAFSA) to the scholarship committee for review.CAPTCHA Δ