East Point/College Park Alumnae Chapter

East Point/College Park Academic Scholarship 2012-2013

East Point/College Park Alumnae Chapter

Delta Sigma Theta Sorority, Inc.

Application for Academic Scholarship

(Please type all information)

Complete and return to: Academic Scholarship Program

Educational Development Committee

East Point/College Park Alumnae Chapter

Delta Sigma Theta Sorority, Inc.

P.O. Box 578

Red Oak, Georgia 30272

INFORMATION AND INSTRUCTIONS FOR APPLYING FOR THE EAST POINT/ COLLEGE PARK ACADEMIC SCHOLARSHIP

1.  A complete application packet MUST be postmarked by January 31st prior to the academic year for which the aid is requested, in order to be considered.

2.  Omission of any part of the application will eliminate the application from consideration.

3.  Applicants may apply for financial aid to complete undergraduate/collegiate work only. Scholarship awards are for tuition and book expenses.

4.  All academic scholarship awards will be awarded upon verification of enrollment from a college or university. Verification entails an enrollment form completed by the institution with the registrar’s signature and official seal of the institution. Scholarship checks will be made payable to the recipient and the college/university.

PART I – PERSONAL DATA

Name ______

Last First Middle

Home Address: ______

Number Street Apt. No.

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City State Zip Code

Home Telephone Number: ______

E-Mail Address: ______

PART II – EDUCATIONAL DATA

Name of High School: ______

School Address: ______

Number Street

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City State Zip Code

School Telephone Number: ______

PART III – HONORS, SPECIAL TALENTS & WORK EXPERIENCE

1.  List honors and awards:

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PART III – HONORS, SPECIAL TALENTS & WORK EXPERIENCE (Continued)

2.  List extracurricular activities - organizations and clubs (indicate years of involvement and

any offices held):

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3.  List community involvement activities:

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4.  List any work experience (Give job title, employer and dates of employment beginning with your current or most recent job):

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5.  Describe other work experiences (such as family business or helping at home):

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PART IV – ESSAY

Describe in 500 words or less in your own words why you want to be a recipient of an East Point/College Park Alumnae Chapter Academic Scholarship. Indicate the course of study you plan to follow, your proposed occupation or profession, and any other skills/abilities you have that were not previously mentioned in this application.

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NOTE TO Please WRITE your name in the blank below then submit this form to

STUDENT: the counselor to obtain the required information.

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Student’s Name

PART V – COUNSELOR VERIFICATION

THE FOLLOWING INFORMATION SHOULD BE COMPLETED BY YOUR HIGH SCHOOL COUNSELOR ONLY:

1.  College entrance examination score (ACT or SAT)

Highest ACT Composite Score: ______

Highest SAT Math Score: ______Highest SAT Verbal Score: ______

2.  Cumulative High School grade point average (GPA): ______

3. Class Rank Number: ______in a class of ______

4. Please rate the applicant’s personal characteristics:

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Counselor’s Signature Telephone Number Date

NOTE TO Please return the form to the student as it is the student’s responsibility

COUNSELOR: to return it to East Point/College Park Alumnae Chapter, Delta Sigma Theta Sorority, Inc., P.O. Box 578, Red Oak, Georgia 30272.

PART VI – RECOMMENDATIONS

1. Please submit recommendation letters from EACH of the following:

(a)  Guidance Counselor or Core Academic Teacher (Academic & Personal Recommendation)

(b)  Community Service Leader (Community Service Recommendation)

(c)  Minister, civic leader, or professional person (Character Recommendation)

Each reference letter should include the name and occupation of each reference, how long they have known you, what type of community activities you have been involved and some information about your involvement. The letters of recommendation should be submitted in a sealed envelope with the reference’s signature across the sealed portion. A total of three letters of recommendation should be submitted in your application packet.

FOR ALL APPLICANTS

I hereby declare that all of the above statements are true. I have also included with this application the necessary official transcript and three letters of recommendation in sealed envelopes. I agree to accept the decision of the Educational Development Committee of the East Point/College Park Alumnae Chapter of Delta Sigma Theta Sorority, Inc.

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Student’s Signature Date