APPLICATION DEADLINE: Friday, May 10, 2019.


1. Complete a copy of this application.

2. Attach a copy of your student resume with ONLY your student ID number on it. The resume should contain a list of your high school years 9-12 extra-curricular activities (including jobs), community service, organizations, honors/awards, as well as time commitments towards each.

3. The applicant must provide a FAFSA statement confirming an Expected Family Contribution amount of $50,000 or less. NO APPLICATIONS WILL BE CONSIDERED WITHOUT A FAFSA STATEMENT.

4. You must obtain and provide a copy of your transcript with your name and address removed. After the selection has been made, the scholarship recipients name will be obtained from the guidance counselor.

5. The applicant must write a one-page, 250-400-word, essay on this topic: “Indicate a person who has had significant influence on you and describe that influence.”.

Additional Information/Requirements:

Scholarships Awards:

● Awards: Multiple awards at $1,000.00 Lions Club Awards.
● Award: One award Barrett Davies Scholarship at $1,500.00


● The applicant must reside in Warren Township or Long Hill Township.

● The applicant must be a senior going to a 2 or 4-year college or certified trade school this fall.

● The applicant must write their student ID Number on the essay and include the name of the college or trade-school destination for the fall. PLEASE DO NOT WRITE YOUR NAME ON THE ESSAY OR ANY OTHER DOCUMENT – ONLY YOUR STUDENT ID. NUMBER.

● The applicant must send the completed documents to: with an email titled: “Warren Lions Club Scholarship Chair.” The application may also be mailed or hand-delivered to Mr. Swanicke’s office at 37 Mountain Boulevard, Warren, NJ 07059. PLEASE ONLY SEND COMPLETED APPLICATIONS.

● Note: The Barrett Davies Scholarship specifically requires that the applicant must plan to study engineering or architecture. Please indicate if your field of study will be architecture or engineering.Applicants for the Barrett Davies scholarship will also be considered for a Warren Township Lions Scholarship.

● The Club considers a combination of financial need, academic performance, community
service/extracurricular activities and the essay in making its award decision.




Name of Scholarship _______________(Barrett Davies or Warren Lions Club)


Student/Family Information


Student ID: _____________  High School Name:_________________________

Guidance Counselor Contact Info: ____________________(Name)

________________(Phone)        ___________________(Email)

Age of All Siblings: ____________________________________

Siblings in Full Time College Next Year: ____________________

Father’s Occupation: ___________________________________

Mother’s Occupation: __________________________________

Student’s Town Residence (Check one): ____ (Warren) ____ (Long Hill Twp)

Unweighted GPA (4.0 scale): ________ Weighted GPA: ________


College Information


College You Plan to Attend :___________________

College  Major   ________________________

Check Which One Applies:

(1) I will commute to college _____ I will live on campus _____

(2) I will begin in the fall ___ spring ___.

(3) My status will be full time____ part time_ ___

(4) College is located in New Jersey___ Out of State ____

(5) College is public____ private ____

(6) Total Cost For College Next year: ________________ (Include tuition, books, fees, room and board or commuting costs. Include the cost for three trips to and from college.)


Financial Information


Have you applied for financial aid? ___ Yes ___No.

If yes, on your Free Application for Federal Student Aid (FASFA) acknowledgement mailed/emailed to you after your
FASA application was processed, find and enter here your assigned Expected Family Contribution (you must also
attached a copy of your provided FAFSA result) $______________.

Indicate what financial aid offers you have received for each source:

                                                               Grant                Loan                Work Study
(1) College Funds:                            __________          __________            __________
(2) State Funds                                 __________          __________           __________
(3) Federal Funds(Pell, etc.)           __________          __________           __________
(4) Business, church, merit           __________          __________           __________
(5) Gifts (relatives, etc.):                __________          __________           __________
(6) Athletic or talent:                     __________          __________           __________
(7) Other:                                          __________           __________          __________
Totals:                                                __________         __________           __________
If your family financial circumstances have changed since filing the FASFA, describe the circumstances below.