Greater Killington Women's Club

formerly Sherburne Women's Club

2017 Greater Killington Women's Club

(formerly Sherburne Women's Club)

Pat Zack Community Service Award

Application Form

The Greater Killington Women's Club (formerly Sherburne Women's Club) is pleased to announce the Pat Zack Community Service Award for the High School Graduating Class of 2017.




PURPOSE:


The purpose of the 2017 Pat Zack Community Service Award is to recognize a Killington/Pittsfield

resident high school senior, who demonstrates impressive service and volunteer work during his

or her time in high school. The primary selection criterion for this award will be community

service. A single $1000 award will be granted.



QUALIFICATIONS:


1. Applicant must be a graduating high school senior.

2. Applicant must be a U.S. Citizen or a permanent resident and a resident of Killington or Pittsfield,

Vermont, for his/her final two years of high school. Students who attend private high schools are

eligible if their primary home is located in Killington or Pittsfield, Vermont, and the above criteria are met.

3. Applicant will be selected according to the following considerations: volunteer work, community service, extracurricular activities, & dedication to others. (Selection is based on, but not limited to, these criteria).

4. The primary selection criterion for this Award will be volunteer work/community service.



SELECTION:


Applicant: Please make use of the following checklist to ensure that you submit all of the required materials.

· A completed Application

· A Personal Essay (see instructions on the following pages)

· Two Recommendation Forms (give one to a high school official and the other to someone who knows you     through your involvement in community service)

APPLICATION INSTRUCTIONS:

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1. Complete and proofread Parts I, II, III and IV of this application.
2. Give Recommendation Forms 1 and 2 to the people from whom you have requested recommendations.
     Make sure to give them the form AND an envelope with your name and address on it. The person                  recommending you should enclose his/her completed form and any additional pages in the envelope,
     seal it, and sign it across the flap of the envelope before returning it to you. You may then submit the
     envelope, unopened, with your application.
3. Submit all parts of the application (including Recommendations 1 and 2) in a single envelope,
     postmarked no later than April 15, 2017.
4. Award recipients will be notified no later than June 15, 2017.
5. Incomplete or late applications will not be considered.

This Award for a maximum of $1000 is non-renewable and contingent upon the availability of funds.


For further information, please contact:

Greater Killington Women’s Club

Attn: Community Service Award Committee

P.O. Box 68

Killington, VT 05751

(802) 775-1575

[email protected]