Delta Sigma Theta Sorority, Incorporated Crimson and Cream and STEM Scholarship Application

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Delta Sigma Theta Sorority, Incorporated Chesterfield Alumnae Chapter 2017 Crimson and Cream and STEM Scholarship Application Applications must be postmarked and returned via mail to: Scholarship Committee Delta Sigma Theta Sorority, Inc. P.O. Box 2554 Chesterfield, VA 23832 By March 17, 2017 For additional information contact: Scholarship Chair at scholarship@chesterfielddst.org

CHESTERFIELD ALUMNAE CHAPTER Delta Sigma Theta Sorority, Incorporated Chesterfield, Virginia 2017 Delta Sigma Theta Sorority, Inc. is a predominantly African American Sorority committed to scholarship and public service. The Organization awards scholarships to African American students that have exemplified academic excellence and extraordinary involvement in extracurricular activities and community service. Please complete the attached application in its entirety to be considered. Three scholarships will be awarded in the amount of $1,000.00 for the Crimson and Crème. One STEM scholarship for $1,000.00 Date of Application Please select the scholarship you are interested in being considered for: Crimson and Creme Award candidate must be a undergraduate college student continuing their education with a cumulative G.P.A. of 75 or higher (2) Stem Scholarship- Candidate must pursue a major in a Science, Technology, Engineering or Math. Failure to pursue a major in a STEM program will result in the award being rescinded. Candidate must be a undergraduate college student with a cumulative G.P.A. of 75 or higher. $1000.00 (2) FOR STUDENTS AND PARENTS We hereby certify that the information on this application is true and complete to the best of our knowledge and belief. Applicant s Name (please print) Signature of Applicant Date: Signature of Parent/Guardian Date: 2

Application Check List Δ Completed and signed application Δ Letters of Recommendation: All letters must be dated and limited to one page. One letter from a community service organization or other institution, on official letterhead, describing your community involvement. Community involvement must be of a voluntary nature and cannot be compensated. One letter from a high school/college official, on official school letterhead, regarding your performance in school and extra-curricular activities. One character reference letter from someone other than a relative. (A Delta Sigma Theta Sorority member is desirable, but not required.) Δ An OFFICIAL SCHOOL TRANSCRIPT: Transcript must include the Fall Semester of 2016-2017 school year - due March 17, 2017. Transcripts must be in a sealed envelope. **PHOTOCOPIES/FACIMILIES WILL NOT BE ACCEPTED** Δ A five hundred (500) word personal statement, which should include goals, accomplishments, community involvement, and reasons why you should be considered for our scholarship. Δ Copy of FAFSA Federal Student Aid Report (SAR), for Financial Aid Award only. ***Any missing items will result in an incomplete package and will not be considered for the award. *** 3

ELIGIBILITY REQUIREMENTS Δ Candidate must be a high school senior who plans to attend an accredited two or four-year college or university. Δ Candidate must be of African American, Caribbean American, or African descent. Δ Candidate must be a United States citizen or permanent United States Resident. Δ Candidate must reside in Chesterfield or Powhatan County. Δ Candidate must have demonstrated academic achievement for the following: Community Service Award - 5 cumulative GPA Financial Aid Award 5 cumulative GPA Minerva Award 5 cumulative GPA Δ Candidate must meet with the Scholarship Committee for a personal interview. **The children of Sorors of Delta Sigma Theta Sorority, Inc. are not eligible to receive scholarship awards from the Chesterfield Alumnae Chapter.** 4

Directions: Provide all information requested below. I. Applicant Information First Name Middle Name Last Name Gender Street Address City State Zip Home Phone Cell Phone E mail Address Date of Birth (Month/Day/Year) Place of Birth (City and State) High School High School Attending Grade Overall GPA Address City State Zip College/University and Major College/University Location (City and State) Intended Major/Field of Study Intended Minor/Field of Study II. Parent/Guardian Information Name of Mother/Guardian Mother/Guardian s Address (if different from applicant s) City State Zip Mother s Work Phone Mother s Home/Cell Phone Mother s Occupation Mother s Employer Name of Father/Guardian Father/Guardian s Address (if different from applicant s) City State Zip Father s Work Phone Father s Occupation Father s Home/Cell Phone Father s Employer 5

III. Financial Need Check the box below that best describes your family s combined gross income. Income should include employment, SSI, FIA, alimony, child support, disability, etc. Proof of income may be required. $0 $14,999 $15,000 $29,999 $30,000 $49,999 $50,000 $74,999 $75,000 $99,999 $100,000 or more Number of Dependent Children in Family Signature of Parent/Guardian (not needed if applying as an independent student) Number of Dependent Children Currently Attending a College/University Date IV. Honors and Awards (e.g., academic, athletic, community, and/or school awards) Award Source of Award Reason(s) for Award V. Extra Curricular/Community Service Activities (e.g., school, religious, social groups) Name of Group/Activity Grade (Check boxes that apply.) 9 10 11 12 Leadership Position(s) Held 6. 7. (College activities if applicable): 6

VI. Colleges and Universities Name of School to Which You Applied City/State Status of Application 6. VII. Financial Awards and Scholarships Scholarship, Loan, Grant, or Award Applied For Awarding Organization Amount Expected, Amount Awarded Total Amount Awarded (Received) Total Amount Expected (Not Received) VII. Work/Volunteer Experience Employer/Organization Dates of Employment/Service Total Hour of Service Position Held 7

IX. Essay In a five hundred (500) word essay please share why the Chesterfield Alumnae Chapter should consider you for this scholarship. Please include goals, accomplishments, and community involvement. 8

You will be notified of the day/time for your interview from the following schedule: (Note: Only qualified applications will be granted an interview. Submission of an application does not guarantee an interview.) Wednesday, March 29, 2017 (6:00pm-9:00pm) Friday, March 31, 2017 (6:00-9:00) Saturday, April 1, 2017 (10:00- ) Please attach a small photo of yourself I hereby certify that all the information provided in this application is accurate and current. I understand this application packet will be kept confidential, and all materials submitted become the final property of the Chesterfield Alumnae Chapter of Delta Sigma Theta Sorority, Inc. All application materials are subject to verification. Signature of Applican t Date 9