Pre-Application Check List

Gold Key Qualifications and Information

The Michigan Elks Charitable Grant Fund is offering scholarships for special-needs students who want to pursue higher education at an accredited educational institution or a licensed trade or vocational school. This scholarship is intended to aid qualifying seniors in high school, who could not otherwise continue their education or training past high school, and is available for study at an accredited college, university, licensed trade or vocational school. Our purpose is to help them become self-respecting, self-reliant, self-supporting, contributing members of society.


For the purpose of this scholarship “Special Needs” is a student that is physically challenged, currently eligible for special education services under the Federal guidelines or as may be approved by the Gold Key Commission of the Michigan Elks Association.


Each scholarship award will be in the amount of $2,000.00 per year.  Each may be renewable for up to three additional years, upon re-application by a prior recipient, who must also provide proof of

attendance and good academic standing.  All scholarships are in the form of certificates of award conditioned upon enrollment.


Scholarships are paid directly to the educational institute the student is attending.


Each application must be accompanied by the following:


  1. Official high school transcript(s).
  2. Completed Student Application Form.
  3. A letter of not over 200 words from parent(s)/guardian describing your family obligation, resources and need for financial assistance.
  4. Three letters of recommendation from a high school teacher/counselor, a special educator/therapist, and one other, such as a responsible community member.
  5. The Individual Education Program Report supplied from the students school. A 504 form will also be accepted.
  6. A letter from doctor regarding “special needs” is needed if applicant does not have an I.E.P. or form 504 from the school.
  7. A letter of acceptance from a school if available with the submission of your application, if not available it must be submitted before you will be given any scholarship money.



What is your Father’s annual income before taxes?

What is your Mother’s annual income before taxes?

What is your Gross Income (total of above)?

Number of Dependents (excluding mother and father)

Number of Dependents attending college

Medical and Dental expenses not paid by insurance.

Do you have any Emergency expenses?

What is the market value of home?

What is the balance of your mortgage?

Do you own a business or farm?

If so, what is the market value?

What is the net profit?

What is the value of your bank accounts?

What is the value of any other investments (stocks, etc.?)


Please provide information about yourself and address the following questions.  Use additional paper if needed.

  1. What is the nature and degree of your special needs?
  2. What school will you be attending and why?
  3. What are your educational/career goals?
  4. How do you anticipate financing school?
  5. What special equipment, devices, and/or supportive services do you require?
  6. What are your extracurricular activities, interests and/or hobbies?


All of the above must be submitted online with this application for its consideration and judging.


The application (with all of the substantiating documentation) must be submitted online no later than December 1st.  Judging will take place in February and recipients will be notified no later than March 1st.