Prairie View A&M National Alumni Association Dallas Chapter 2013 Clever Dean Lewis Scholarship Application Application Deadline April 16, 2013 Our Tradition. Your Opportunity.
Prairie View A&M National Alumni Association, Dallas Chapter Award Eligibility $1000 Scholarship to attend Prairie View A&M High School Senior that is a U.S. citizen and attends school in Dallas County who plans on enrolling in Prairie View A&M University in the Fall of 2013 or Spring of 2014 upon graduating from high school. Applicant must have at least a 2.5 Cumulative Grade Point Average on a 4.0 scale in order to qualify for a scholarship. Minimum SAT score (math/reading) of 820 or ACT score (composite) of 17. Applicant must submit a completed application. Applicant must plan to attend the awards ceremony to receive the scholarship or have a representative if he/she is unable to make it. Business attire is required. Family and friends are welcome and encouraged to attend. Applicant must demonstrate financial need. Applicant must agree to release grades from PVAMU to the Dallas Alumni Chapter. Application Requirements The application packet shall consist of: 1. Completed, signed and dated application. 2. Essay on the following topic: Why Do You Want to Attend Prairie View A&M University? See essay requirements below. 3. Scholarship Funds Disbursement Disclaimer signed by a parent or guardian. 4. Two teacher and one counselor recommendation returned in sealed envelopes (see recommendation forms). 5. Official high school transcript that includes first semester grades of the senior year enclosed in a sealed envelope. 6. Signatures required on the grade release form. Essay Requirements On a separate sheet of paper, type a minimum 500 word essay on the following topic: Why Do You Want to Attend Prairie View A&M University? You will be assessed on your ability to communicate your thoughts. Your essay should include reasons for attending PVAMU, personal career objectives, higher education plans, and any additional information you feel will assist the selection committee. The essay should be double-spaced, 12-point Times New Roman font, one inch margins on all sides, with your name typed in the upper right-hand corner of each page. The application must be received by April 16, 2013. Please send it to the person below. Pamela Brown, Scholarship Committee Chair 3909 Morning Frost Trail Dallas, Texas 75224
Prairie View A&M National Alumni Association, Dallas Chapter SECTION I: PERSONAL INFORMATION Please clearly print or type all information in black ink. Name Date of Birth Sex Address City State Zip Code Phone Number Email Address Father s Name Employer Phone Number Occupation Mother s Name Employer Phone Number Occupation Guardian s Name Phone Number Employer Occupation SECTION II: SCHOOL INFORMATION High School School Address City State Zip Code Class Rank of GPA GPA Scale Anticipated Major SECTION III: Financial Need Number of People in the Immediate Family Family Income Other Reasons for Financial Need
SECTION IV: ACTIVITIES, SERVICE AND HONORS (Attach additional sheets if necessary.) Extracurricular Activities Activity Description Dates of Activity Volunteer Work and Community Service Organization Description of Service or Work Dates of Service Honors and Awards Honor/Award Description Date Received The information submitted in this application is true and correct. Also, I will sign a letter authorizing the Registrar of Prairie View A&M University to send my first and second semester grades to the Prairie View A&M University Alumni Association-Dallas Chapter (PVAMUAA-D) promptly upon the grades becoming available. Finally, PVAMUAA-D has my permission to publicize that I am a PVAMUAA-D Scholarship Recipient. Parent Signature Date Student Signature Date
Scholarship Application Disclaimer Agreement for Disbursement of Scholarship Funds I,, acknowledge and understand that any scholarship award received by my child,, will only be disbursed as two separate payments directly to Prairie View A&M University. One payment will be received in the Fall and one payment will be received in the Spring. No checks will be issued directly to the award recipient. All checks will be made payable to Prairie View A&M University. The scholarship award must be claimed during the 2013-2014 academic year, or it will be forfeited. No exceptions will be given. I recognize and accept these conditions for the disbursement of any scholarship award my child may receive. Parent/Guardian Signature Date
PRAIRIE VIEW A&M UNIVERSITY NATIONAL ALUMNI ASSOCIATION DALLAS CHAPTER A Proud Tradition Grade Release Form I, Name of Student Social Security No. hereby give permission to Prairie View A&M University to forward my final grades at the end of the Fall term and Spring term to: PRAIRIE VIEW A&M UNIVERSITY ALUMNI ASSOCIATION-DALLAS CHAPTER, P.O. Box 397508, Dallas, Texas 75339 Student Signature Address City State Zip Code Telephone Number: Date: Signature of Parent or Guardian Address City State Zip Code Telephone Number: Date:
PRAIRIE VIEW A&M UNIVERSITY NATIONAL ALUMNI ASSOCIATION-DALLAS CHAPTER TEACHER RECOMMENDATION FORM STUDENT NAME YEARS KNOWN STUDENT: IN WHAT CAPACITY? PLEASE RANK THE STUDENT IN THE CATEGORIES LISTED BELOW BY CHECKING THE APPROPIATE BOX. Writing Skills Verbal Skills Analytical Ability Logical Reasoning Organization Skills Leadership Self-Discipline Ability to Work with others Maturity Integrity Initiative Judgment Truly Outstanding Excellent Good Average Below Average Comments: STRONGLY RECOMMEND RECOMMEND RECOMMEND/RESERVATIONS DO NOT RECOMMEND NAME POSITION/TITLE SCHOOL TELEPHONE NO. ADDRESS CITY STATE ZIP CODE EMAIL ADDRESS: Seal the completed recommendation form in an envelope and sign your name across the seal. Return the signed, sealed envelope to the applicant. If you do not want to return the recommendation to the applicant, you can send it directly to scholarship chair (information below). Form must be RECEIVED by April 16, 2013. PLEASE SEND TO: Pamela Brown 3909 Morning Frost Trail Dallas, Texas 75224
PRAIRIE VIEW A&M UNIVERSITY NATIONAL ALUMNI ASSOCIATION-DALLAS CHAPTER TEACHER RECOMMENDATION FORM STUDENT NAME YEARS KNOWN STUDENT: IN WHAT CAPACITY? PLEASE RANK THE STUDENT IN THE CATEGORIES LISTED BELOW BY CHECKING THE APPROPIATE BOX. Writing Skills Verbal Skills Analytical Ability Logical Reasoning Organization Skills Leadership Self-Discipline Ability to Work with others Maturity Integrity Initiative Judgment Truly Outstanding Excellent Good Average Below Average Comments: STRONGLY RECOMMEND RECOMMEND RECOMMEND/RESERVATIONS DO NOT RECOMMEND NAME POSITION/TITLE SCHOOL TELEPHONE NO. ADDRESS CITY STATE ZIP CODE EMAIL ADDRESS: Seal the completed recommendation form in an envelope and sign your name across the seal. Return the signed, sealed envelope to the applicant. If you do not want to return the recommendation to the applicant, you can send it directly to scholarship chair (information below). Form must be RECEIVED by April 16, 2013. PLEASE SEND TO: Pamela Brown 3909 Morning Frost Trail Dallas, Texas 75224
COUNSELOR SCHOLARSHIP RECOMMENDATION IS AN APPLICANT FOR A SCHOLARSHIP TO ATTEND PRAIRIE VIEW A & M UNIVERSITY. THE DALLAS PRAIRIE VIEW ALUMNI SCHOLARSHIP COMMITTEE WOULD GREATLY APPRECIATE YOUR COMMENTS REGARDING THE APPLICANT S PERSONALITY, CHARACTER, ACADEMIC POTENTIAL AND ACHIEVEMENT, AS WELL AS THE LEADERSHIP ABILITY OF THIS STUDENT. HIGH SCHOOL ACCREDITED BY STUDENT S GPA: ON A SCALE OF STUDENT S RANK IN CLASS OUT OF SAT Date: Critical Reading: Math: Writing: ACT* Date: Composite Score: WOULD YOU RECOMMEND THIS STUDENT AS HAVING THE APTITUDE AND ACADEMIC RECORD APPROPIATE TO BACCALAUREAT STUDIES AT PRAIRIE VIEW A&M UNIVERSITY? Highly recommended Recommended with reservation Unable to judge at this time Recommended Not recommended Prefer not to respond PLEASE MAKE ANY OTHER COMMENTS BELOW THAT YOU FEEL ARE PERTINENT. NAME POSITION TELEPHONE MAILING ADDRESS CITY STATE ZIP CODE E-MAIL ADDRESS SIGNATURE Seal the completed recommendation form in an envelope and sign your name across the seal. Return the signed, sealed envelope to the applicant. If you do not want to return the recommendation to the applicant, you can send it directly to scholarship chair (information below). Form must be RECEIVED by April 16, 2013. PLEASE SEND TO: Pamela Brown 3909 Morning Frost Trail Dallas, Texas 75224
Completed Application Checklist Before sealing your package, please make sure that all items listed below are included: Scholarship Application Essay (Typed) Disclaimer for Scholarship Funds Disbursement (Signed) Three recommendation forms (two teacher forms and one counselor form-sealed and signed) Official High School Transcript (Sealed) Grade Release Form PLEASE SEND THE ENTIRE APPLICATION BY APRIL 16 TH TO : PAMELA BROWN 3909 MORNING FROST TRAIL DALLAS, TEXAS 75224 Missing any of the above items will result in an incomplete packet and will not be considered for an award.