2024

SEND APPLICATION AND DIRECT ANY QUESTIONS TO:

Deadline: Contact local Zonta club for deadline.

Zonta Club/e-Club of:
District/Area:
To find a club click: Club Locator
Attention:
Address:
City/State:
Province/Country:
Telephone:
Email address:

Name:
Last (Family) First Middle

Current mailing address:

City: State: Postal Code: Country:
Email address: Telephone:
LinkedIn address: Twitter handle:

Permanent mailing address:

City: State: Postal Code: Country:
Secondary email address: Telephone:
Birth date: Birthplace: Country of citizenship:
(mm/dd/yyyy) (city and country)

Name of university/college/institute currently attending:

Current year of study:

Department: Major/field of study:

Plans for study under the JMK Women in Business Scholarship:
Degree sought: Expected graduation date (month/year):

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Academic background
Applicants are required to send transcripts of grades or equivalent records from all universities, colleges or institutes
attended. An explanation of the grading system must be included for each transcript. Please add your current degree sought
and expected graduation date (month/year).

University/College (Year) to (Year) Major Field Date Degree Received/Anticipated Maximum GPA

Scholarships, fellowships, honors received during the studies listed above

Month/year

Volunteer and Other Activities

(Please describe your volunteer, non-scholastic activities, memberships and cultural interests):

Employment history
From To Type of work or position held
Employer Address
(month/year) (month/year)

Recommendations
Please give one of the attached recommendation forms to a faculty member in the major field of study and the other to an
employer, volunteer supervisor or academic adviser.

Please list below those who will submit recommendations:

Name Position College/university/institute

1.

2.

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Declaration by applicant
I certify that all the information contained in my application form is accurate to the best of my knowledge and that I did not
receive assistance in completing the essay portions of this application other than for translation into English for advancing to
district/region and international levels. I understand that, at the option of the Zonta club sponsoring my application or the
Zonta district/region, or Zonta International, I may be interviewed as a candidate for the Jane M. Klausman Women in
Business Scholarship. I consent to the electronic or hard copy publication of material in my application by Zonta
International.

❑ I confirm that I have not applied to more than one Zonta district.
❑ I confirm that I am not a family member (ancestor, descendant, adoptee, sibling, niece or cousin and those of
their spouse or co-habiting partner)) of a club member and individual with direct membership with Zonta
International, and/or employee of Zonta International.

Signature (required) Date

(Insert image of your signature or print, sign and scan this page.)

Data protection
Zonta International and Zonta Foundation for Women take the security of your data seriously. We will never sell, trade or
rent your personal information provided in this application to third parties. By submitting this application, you agree to the
use of your data in accordance with the Privacy Policy and Publicity Authorization Form contained in the application documents
(see page 8 of the application).

How did you learn of the Jane M. Klausman Women in Business Scholarship? Applicant checklist
Please check the appropriate items: Please check all items included with the application:
Social media Completed application
Facebook Official copies of all transcripts
LinkedIn Recommendation letter cover sheets with
Twitter dates and signatures
Department/teacher Recommendations (2)
Directory of grants at university financial aid office Essay (not exceeding 500 words)
Directory of grants not at university (e.g., public libraries) Zonta International verification of current
Website (name): enrollment form (page 11) with official stamp
Zonta club member: of the college/university/institute
Zonta Club of: Signatures
Other:

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Professional information and goals
(Please type essay.)
In 500 words or less, please describe your academic and professional goals, the relevance of your program to the business field, how you
have demonstrated initiative, ambition and commitment to pursuing a career in business, and how the Zonta International Jane M.
Klausman Women in Business Scholarship will assist you in reaching your goals. (Essays cannot exceed 500 words to be considered.)
Please provide the word count at the end of your answer.

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 Recommendation for Jane M. Klausman Women in Business Scholarship

Please return this form by:

Applicant’s Signature is required (Insert image of your signature or print, sign and scan this page.)

Applicant:
Last (Family) Name First Middle
Recommendation from:
Name Position/Title

College/university/institute/business/organization

The applicant above has applied for a Jane M. Klausman Women in Business Scholarship. The Jane M. Klausman Women in
Business Scholarship Evaluation Committee greatly values and appreciates your opinion. Please discuss the applicant’s
accomplishments; current academic program or work experience; intellectual independence; capacity for analytical
thinking; ability to organize and express ideas clearly; creativity; motivation; and potential for learning and succeeding in a
business-related field. You may write your recommendation letter on letterhead of your choice; however, you must sign
and submit this form with your letter of recommendation to the address below.

How long have you known the applicant?

Please rate the applicant with respect to your experience with other students/employees in this field/position:

Exceptional Very Good Good Average Below Insufficient opportunity to

Top 5% Next 10% Next 15% Next 30% Average observe
Last 40%

Signature is required (Insert image of your signature or print, sign and scan this page.) Date

Return form to Mailing

Zonta Club of: Address:
City: State/Province:

Postal Code: Country:

Fax: Email Address:

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 Recommendation for Jane M. Klausman Women in Business Scholarship

Please return this form by:

Applicant’s Signature is required (Insert image of your signature or print, sign and scan this page.)

Applicant:
Last (Family) Name First Middle
Recommendation from:
Name Position/Title

College/university/institute/business/organization

The applicant above has applied for a Jane M. Klausman Women in Business Scholarship. The Jane M. Klausman Women in
Business Scholarship Evaluation Committee greatly values and appreciates your opinion. Please discuss the applicant’s
accomplishments; current academic program or work experience; intellectual independence; capacity for analytical
thinking; ability to organize and express ideas clearly; creativity; motivation; and potential for learning and succeeding in a
business-related field. You may write your recommendation letter on letterhead of your choice; however, you must sign
and submit this form with your letter of recommendation to the address below.

How long have you known the applicant?

Please rate the applicant with respect to your experience with other students/employees in this field/position:

Exceptional Very Good Good Average Below Insufficient opportunity to

Top 5% Next 10% Next 15% Next 30% Average observe
Last 40%

Signature is required (Insert image of your signature or print, sign and scan this page.) Date

Return form to Mailing

Zonta Club of: Address:
City: State/Province:

Postal Code: Country:

Fax: Email Address:

6
 Verification of Current Enrollment for
Jane M. Klausman Women in Business Scholarship

I certify that is currently enrolled in

(full name of student)

in
(year of degree program) (name of course/degree being studied)

at
(name of college/university/institute)

(address college/university/institute)

(signature is required of college/university/institute official) (date) (Expected graduation date)

(official stamp of the college/university/institute

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 Privacy Policy and Publicity Authorization
Zonta International Jane M. Klausman Women in Business Scholarship Program

Zonta International and the Zonta Foundation for Women are committed to honoring the privacy and wishes of all of our
Jane M. Klausman Women in Business Scholarship recipients at all times. In order to do this, please read the following
information carefully and indicate your agreement as appropriate.

1. Most data collected by Zonta International and the Zonta Foundation for Women is used only to help Zonta better
serve its scholarship recipients. It is our general policy to collect and store only personal information that our
recipients knowingly provide. Zonta does not sell, trade, or rent your personally identifying information to third
parties. Except as described in paragraph two, we take reasonable measures not to disclose personally identifying
information about you.

I have read the above paragraph and agree to the Terms and Conditions therein.

2. From time to time, Zonta International and the Zonta Foundation for Women conducts various marketing activities
to promote the Jane M. Klausman Women in Business Scholarship Program. In addition, to ensure Zonta’s ability to
fund the Scholarships, the Zonta Foundation for Women may from time to time provide information to donors to
the Jane M. Klausman Women in Business Scholarship Fund about recipients of their donations. Zonta retains the
right to use your name, photograph and biographical information to promote the Jane M. Klausman Women in
Business Scholarships in various promotional materials, including the website.

I have read the above paragraph and agree to the Terms and Conditions therein.

Please print your name

Signature is required (Insert image of your signature or print, sign and scan this page.) Date