A Public Service Sorority Atlanta Alumnae Chapter SCHOLARSHIP APPLICATION PACKET Application Instructions Please type or print the application legibly in black or blue ink Applications must be submitted in one packet by the Counselor to the Scholarship Committee Submit the completed application, letters of recommendation, and transcripts to: Delta Sigma Theta Sorority, Inc. Atlanta Alumnae Chapter c/o Elizabeth R. Murray, Chair Scholarship Committee 1345 Oakcrest Dr SW Atlanta, GA 30311 Counselor s Signature Date DEADLINE: A complete application packet with postmark date by FRIDAY, DECEMBER 11, 2015. Page 1 of 6
Delta Sigma Theta Sorority, Inc. Atlanta Alumnae Chapter SCHOLARSHIP GUIDELINES Purpose The Atlanta Alumnae Chapter of Delta Sigma Theta Sorority is committed to maintaining the tradition of service to the community. As one of our public service programs, the chapter awards scholarships to eligible students for the purpose of continuing their education. Awards Scholarship amounts vary from year-to-year. The number of scholarship awards is determined by the available funds from the sorority s scholarship fundraiser. Eligibility Criteria To be eligible for an AAC scholarship, you must: 1. Be a graduating high school senior from an Atlanta Public School. 2. Have a minimum numerical grade point average of 80 or a grade point average of 3.0 3. Have a minimum SAT score of 970 from the Critical Reading and Math Sections only or an ACT composite score of 20 4. Have a strong financial need 5. Be accepted and verify enrollment at a college or university. 6. Participate in an interview with the Atlanta Alumnae Chapter Scholarship Committee 7. Not be a relative of any member of Delta Sigma Theta Sorority, Inc., Atlanta Alumnae Chapter. 8. Demonstrate outstanding leadership skills and participate in community service activities. Application Requirements The applicant shall provide the Scholarship Committee a complete application packet that includes: 1. Completed scholarship application written legibly in blue or black ink or typewritten 2. Official high school transcript 3. SAT or ACT Scores 4. Two reference letters in sealed envelope with the signature across the seal from each person. Letters of reference must be written, by a counselor, school administrator, teacher, and/or the person, who verifies your community service participation. All letters must be written on letterhead. 5. A photo of the applicant. 6. Completed Media Release Form signed by applicant and parent/guardian. 7. Family Financial Information 8. Personal essay (See instruction on application form) 9. Applicant Signatures Limitations a. Scholarships are granted on a one-time only basis for the first year of attendance at a college or university. b. A four-year renewable scholarship (is) (can be) awarded to one eligible recipient every four years. c. Award recipients must be enrolled in college or university that is accredited by a Regional Accrediting Agency such as (1) The College Handbook by The College Board, (2) Peterson s College Guide, and (3) US World & News College Guide. The scholarship money will not be forwarded to the respective school until an official Verification of Enrollment document is completed and returned to the Scholarship Committee by the Registrar s Office. d. The Scholarship check is made payable to the College/University and is sent directly to the school e. Scholarship awards must be used for payment towards tuition, room and board, books and/or other required fees only. Additional costs of travel, personal needs and incidentals are the responsibility of the individual. f. The Atlanta Alumnae Chapter reserves the right to rescind the award as indicated in the Applicant Certification (See Number 20 on the application form). Application Deadline The complete scholarship application, with postmark date by FRIDAY, DECEMBER 11, 2015. Page 2 of 6
APPLICANT INFORMATION ATLANTA ALUMNAE CHAPTER SCHOLARSHIP APPLICATION 1. Name High School Copy Required: G.P.A. SAT ACT Critical Reading Math Composite Score 2. Date of Birth Social Security Number 3. Address City State Zip Code 4. Telephone Number E-Mail Family/ Financial Information Parents/Guardian Marital Status: Single Married Divorced Separated Father Tel. No.: Address City State Zip Code Place of Employment: Occupation: Income Range Benefits received in most recent tax year: Yes No Social Security benefits received by family Welfare benefits received by family Child support received for all children Page 3 of 6 Mother Tel. No.: Address City State Zip Code Place of Employment: Occupation: Income Range 7. Number of people in the home: Adults Children under 18 Does parent/guardian own home? or rent? 8. Number in school: Elementary Middle High College College Application Information 9. Have you filed a Free Application for Federal Student Aid (FAFSA)? 10. List the colleges and universities to which you have applied: 11. List the colleges or universities from which you have received Have you receive a scholarship? If Yes, List Amount acceptance letters: Yes No
12. List other types of financial aid, scholarships, or loans for which you have applied: 13. What is your career goal? Attach Photograph Here Activities 14. List your community/volunteer service (exclude community service required for graduation): 15. List extracurricular activities, special talents, club affiliations (include offices held): 16. List special honors and/ or awards received (list dates, if possible): 17. List your work experiences, including dates of employment and job duties: I, the undersigned, do hereby affirm that all information provided herein is true and complete to the best of my knowledge. Misrepresentation or the submission of inaccurate or incomplete information will result in disqualification or forfeiture of any award. Page 4 of 6
Applicant s Signature Date: Essay 18. On a separate sheet of paper, briefly explain why you should receive this award (describe your financial need): (250 words minimum written legibly in blue or black ink or typewritten) References 19. List names and addresses of two (2) persons who will submit letters of recommendation for you (See Requirement): a. Teacher/Counselor, Church/Community Reference: Name Position Address City State Zip Code b. Teacher/Counselor, Church/Community Reference: Name Position Address City State Zip Code 20. APPLICANT CERTIFICATION In submitting this application, I hereby certify that: I fully understand that if an award is given to me, it is for the purpose of giving financial assistance as a college/university freshman. Request for funds shall be on or before October 1 st or February 15 th, of your freshman year. In the event that I do not enter a college or university by the first or second semester/quarter after high school graduation, I forfeit my scholarship from the Atlanta Alumnae Chapter. Moreover, if I receive other financial assistance that fully covers, ALL tuition, room and board, class material costs and fees after the Atlanta Alumnae Chapter has notified me of an award, I will notify the chapter of this scholarship and relinquish claim to the award granted by the Atlanta Alumnae Chapter. I further acknowledge that I have read and I understand the Eligibility Requirements and Statement of Limitations of the scholarship program sponsored by the Atlanta Alumnae Chapter of Delta Sigma Theta Sorority, Incorporated. Signature of Applicant Date Signature of Parent/Guardian Date Page 5 of 6
Application Check List Please complete the following checklist to ensure that all requirements and documentation associated with your application have been completed and included. 1. Completed application form 2. Copy of SAT or ACT scores 3. Official High School Transcript 4. Family financial information 5. Two letters of recommendation in sealed envelopes with the signature across the seal from each person listed as a reference 6. A photo of the applicant 7. A Media Release form signed by applicant and parent/ guardian 8. Essay 9. Signature of applicant after Question #17 and Applicant Certification (below) YES NO Page 6 of 6