Scholarship Application Template 2003



Scholarship APPLICATION

|Please type your answers. |

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|1. |Last Name: |First Name: |

|2. |Mailing Address |

| |Street: |

| |City: State: Zip: |

| |Daytime Telephone Number: ( ) |

|3. | |

| |Email Address: |

|4. |Date of Birth: Month Day Year Gender: |

|5. |Cumulative Grade Point Average (GPA): __________ (On a 4.0 scale) |

| |Attach proof of GPA. Your most recent school transcript is required, or print out from your online account. |

|6. |Ritual Certificates Received: |

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|7. |List membership in Campus or Local/Civic organizations and activities; provide contact information for advisor of the organization or other representative that |

| |may verify membership. |

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|8. |Leadership positions held in Fraternity or other organizations: |

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|7. |Initiation Date: |

|8. |Academic Major and Advisor contact information: |

9. On a separate sheet please write an essay (250 - 500 words) answering the questions below:

Describe how you plan to improve the chapter, include goals, initiatives, and any other information you deem necessary. Be sure to include how you plan to get the members of the chapter to support your vision. Be as specific and detailed as you can.

Signature of scholarship applicant: ___________________________________ Date: ___________________

REMINDER:

The deadline for this application to be received is:

January 17, 2020 NO EXCEPTIONS!

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