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Kiwanis Club of St. Petersburg, Florida, Inc

Alfred J. Muter Scholarship &

Ronald Holehouse Scholarship

Provided for High School Seniors who are Residents of Pinellas County


Student Application

Part 1

Date of Birth
Month
Day
Year
Gross Family Income
Under $25,000
25,000 - 50,000
50,000 - 75,000
75,000 - 100,000
100,000 - 150,000
150,000 and above

*The Kiwanis Club of St. Petersburg reserves the right to request documentation that supports this figure prior to disbursement of any scholarship funds.

Applicant lives with
Both Parents
Mother
Father
Guardian

Kiwanis Club of St Petersburg

PO Box 12686

St Petersburg, FL 33733

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© 2017 by Kiwanis of St. Petersburg, Florida

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