The Delta Kappa Gamma Society International

The Delta Kappa Gamma Society International

Alpha Beta State Organization

Scholarship Application

Date Submitted______Date Received______

Name ______

Address______

E-Mail Address ______

Member of ______Chapter Number of years in Maryland ______

(3 years minimum in DKG for eligibility)

Initiation Date______Dues Paid ______

Month/ Year Year Chapter Treasurer’s Signature

Delta Kappa Gamma Involvement- Briefly describe your involvement in your local chapter (i.e., offices held, committees served on, programs presented, community service)

______

Please check which Scholarship you are applying for:

_____Dr. Anne H. Matthews

_____Esther J. Crooks

_____Dr. Fern D. Schneider

_____The Founders

The following information is needed only for the Dr. Anne H. Matthews, Esther J. Crooks, and Dr. Fern D. Schneider Scholarships:

Name of the institution attending ______

Is this institution a fully accredited institution recognized by the Maryland Department of Education? Yes ______No______

Course(s) enrolled______Semester/Year_____

______Semester/Year_____

Number of Credits to be earned: ______

Credits will be used towards: National Teacher Board Certification ______

Certificate Renewal ______Master’s Degree ______Doctoral Degree ______

Educational Costs: # of credits ______

Cost/credit ______

Additional expenses______

Total cost for course(s) ______

Is reimbursement provided by your local school system?

Yes______Amount ______

No ______

Are you applying for an International Scholarship through DKG? Yes ____ No _____

(International scholarship winners are not eligible to receive a state scholarship in the same year.)

*For those applying for the Founders Scholarship, please state the

Name of the Program______

Length of Program ______

Attach printed documentation of enrollment in lectures, workshops, courses, series, and/or program description.

Upon notification of receiving an Alpha Beta State Scholarship, I agree to attend the State Leadership Workshop or State Convention program to receive the award. I also agree to submit a brief article for the October issue of the Alpha Beta State News detailing the use of my scholarship as it relates to my program of study.

______

Signature of Applicant

Each application should be accompanied by:

*A personal résumé (maximum of 3 pages) that includes:

-A Brief Personal Background

-Educational Background

-Professional Experiences and Organizations

-Community Activities

-Publications, if any

*A letter of recommendation from your Principal, Supervisor or other educator.

*A letter of recommendation from your DKG Chapter President

Applications are to be postmarked by January 16th

to the current Alpha Beta State Scholarship Chairman.