College Scholarship Application Deadline: January 31, 2015

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Delta Sigma Theta Sorority, Inc. Macon Alumnae Chapter College Scholarship Application Deadline: January 31, 2015 2015 College Scholarship Application Requirements! Scholarship Eligibility Requirements: 1. African American High School Seniors (male and female) who reside or attend high school in Bibb, Jones, Wilkinson, Monroe and Twiggs Counties 2. African American GED recipients (male and females) who reside in Bibb, Jones, Wilkinson, Monroe and Twiggs County 3. African American Continuing education students who are currently attending an accredited college, university, or post-secondary institution 1. Application requirements (please follow steps): a. Applicants must have at least a 2.75 Cumulative Grade Point Average on a 4.0 scale in order to qualify for a scholarship. Applicants are required to submit an official high school transcript which includes first semester grades of the senior year enclosed in a sealed envelope. b. Applicants who have a GED are required to obtain a transcript (official copy of GED scores) from the Georgia Department of Technical and Adult Education, Atlanta Georgia enclosed in a sealed envelope. c. Applicants who are currently attending an accredited college, university, or post secondary institution are required to submit an official transcript (including fall 2014 semester grades) with the seal of the college or university affixed in a sealed envelope. d. All applicants are required to submit two letters of recommendations. References can be a teacher, administrator, counselor, minister, employer, community leader, etc. Please note that one letter of reference must come from a teacher or administrator. See instructions to be given to references on page 9. e. All applicants are required to submit a completed, signed and dated application. The application must be typed. (No additional attachments will be accepted except where noted in the application.) f. All applicants are required to submit a typed essay that answers the follow question: Why should I be considered for a Delta Sigma Theta Sorority Scholarship? g. Selected applicants are required to participate in a panel interview in March 2015. Photo identification will be required prior to the interview.

h. Parent/Guardian is required to sign a Scholarship Funds Disbursement Disclaimer. NOTE: Awards are to be used for educational purposes only and funds will not be distributed until winners return the Student Enrollment Verification Form. Funds will be disbursed in the name of the student AND the school. Funds will be mailed to the school. No personal checks will be issued. Incomplete packages will not be considered for an award. Please refer to checklist on page 8 prior to submitting application. 2. The completed application, essay response, letters of recommendation and official transcript must be mailed together as one complete packet to be considered. The package must be postmarked on or before January 31, 2015. (NO EXCEPTIONS) Mail to: Macon Alumnae Chapter Delta Sigma Theta Sorority Incorporated P.O. Box 5041 Macon, Georgia 31208-5041 Attention: Scholarship Committee 3. Completed applications will be reviewed and scored by the Scholarship Committee. The top scoring applicants will be granted an interview in March 2015. All scholarships will be awarded in May 2015. SECTION I: IDENTIFICATION Name: Present Address: City: State: Zip Code: Permanent Address: City: State: Zip Code: E-Mail Date of Birth: Sex: Telephone: (home) (cell) 2 P age

Father s Name: First M.I. Last Father s Address: Employer: Occupation: Mother s Name: First M.I. Last Father s Address: Employer: Occupation: Guardian s Name: First M.I. Last Guardian s Address: Employer: Occupation: SECTION II: SCHOLARSHIP INFORMATION High School: School Address: City: State: Zip Code: College you plan to attend/attending: City/State: Anticipated Major: 3 P age

List all Scholarships applied for and awarded and all financial resources that are available to assist you with your college education: Examples: Pell Grant, Financial Aid, HOPE Scholarship, family church, loans, etc. (Attach an additional sheet if necessary) SECTION III: EXTRA-CURRICULAR ACTIVITY (School/Non-School): List all extra-curricular school, church, or civic activities (attach an additional sheet if necessary) Activity Description Dates of Activity 4 P age

VOLUNTEER WORK AND COMMUNITY SERVICE (attach an additional sheet if necessary) Organization Description of Service or Work Dates of Service HONORS AND AWARDS (attach an additional sheet if necessary) Honor/Award Description Date Received SECTION IV: Essay Instructions On a separate sheet of paper, type a 500 word essay on why you would like to be considered for a Delta Sigma Theta Sorority Scholarship. You will be assessed on your ability to communicate 5 P age

your thoughts. Your essay should be double-spaced, 12 point Times New Roman font, one inch margin on all sides, name typed in the upper right-hand corner of each page. SECTION V: SIGNATURES I certify that information provided in this application is true, complete and accurate and that all statements and essay are my own work. A scholarship award from Macon Alumnae Chapter of Delta Sigma Theta Sorority, Inc. may be denied or revoked if any information contained herein is found to be inaccurate. Should I receive an award, I hereby give Macon Alumnae Chapter of Delta Sigma Theta Sorority, Inc. permission to utilize my name, photographs and award amount in publicity and/or marketing materials. Applicant Signature Parent/Guardian Signature Date SCHOLARSHIP APPLICATION DISCLAIMER AGREEMENT FOR DISBURSEMENT OF SCHOLARSHIP FUNDS I, (Parent/Guardian) acknowledge and understand that the scholarship awards received by the winners will only be disbursed in a lump sum payment directly to the university/college identified by the scholarship recipient (Student s Name). Scholarship Awards must be claimed within 2 years from the date of award, or they will be forfeited. No exceptions. The Macon Alumnae Chapter of Delta Sigma Theta Sorority, Inc. will forward these funds to that institution upon receipt of the Enrollment Verification Form to be placed in the student s account with the Financial Aid Office. 6 P age

The Enrollment Verification Form shall be notarized with the official institution's seal and dated. I recognize and accept these conditions for the disbursement of any scholarship award that my son/daughter may receive. Parent/Guardian Signature Date 7 P age

Application Check List Before sealing your package, please make sure that all items listed below are included: Scholarship Application (Typed) Essay (Typed) Two letters of recommendation (sealed) Official High School, GED or College Transcript (sealed) Disclaimer for Scholarship Funds Disbursement (signed) *Missing any of the above items will result in an incomplete package and will not be considered for an award 8 P age

INSTRUCTIONS TO BE GIVEN TO REFERENCES Please have your references submit a typed letter of recommendation for you. These letters should be addressed to Delta Sigma Theta Sorority, Inc. Macon Alumnae Chapter and include: Name and address of reference Relationship to applicant How long reference has known applicant Information regarding why applicant should receive the scholarship award The Letter should be placed in a Sealed Envelope with their signatures before returning to the applicant. 9 P age