Fully complete each item of information. 
    Note: TYPE or PRINT clearly using Black ink.

1. Full Name: ________________________________________

2. Address: _____________________________

City/State/Zip: _________________________

Telephone: ____________________________

Email: _________________________________

        3. College or University you intend to attend: __________________

4. Major/Concentration: __________________________________

5. Employment Experience: ______________________________
    __________________________________________________

6. Awards, honors, clubs:______________________________

___________________________________________________

        7. Attach a personal essay describing your interest in the American
            political process and the role of today’s youth.
            (Maximum of two typewritten pages, and please double space.)

       8. Attach the completed community service form with at least 10
            hours of service.

       9. Submit two letters of recommendation (in sealed envelopes).

      10. Submit a current academic transcript.

         Sign on the signature line, indicating this application is
         complete and accurate.
         Signature: ________________________________________
         Date: _________
                  
                          Must be postmarked by 1 March, 2008
                          Send completed application with attachments to:
                                   Amy McClary, Scholarship Administrator
                                   8508 N McDonald Ave
                                   Kansas City, MO  64153
 

        Part III. Citizenship Scholarship Recommendation Form:
                     Use this form when asking a person for reference
                          concerning character, abilities and skills. Each
                          recommendation is kept  confidential, and each must be
                          sealed upon receipt.

Name of Applicant: ____________________________________

Name of Reference: __________________________________

Title/Address: _______________________________________
________________________________________

Telephone: ___________________________

How long have you known the scholarship applicant? ______________

In what capacity are you familiar with the applicant’s education and/or personal background? ________________________________________________

Evaluation:

In comparison with a representative group of high school seniors,
how do you rate the applicant in: (1-10 scale with 10 as outstanding)

Leadership potential ___

Motivation and initiative ___

Ability to work with others ___

Imagination and creativity ___

Potential to succeed in ___

General academic ability ___

Please answer: How does the applicant exemplify Republican values?
Or why should this applicant receive this scholarship .
(Use the back of form if more space is needed.)

Signature: ____________________________ Date: ______________________

Return this form to the APPLICANT in a sealed envelope.
Scholarship deadline is: 1 March.