ALPHA KAPPA ALPHA SORORITY, INC.- DELTA IOTA CHAPTER 50 TH ANNIVERSARY SCHOLARSHIP FUND DEADLINE: JULY 6, 2015 The Alpha Kappa Alpha Sorority, Inc.-Delta Iota Chapter created this fund to provide scholarships for students who are matriculating at Cheyney University and demonstrate leadership experience. This fund will support students who have financial need and require assistance continuing their education. This application is open to all Cheyney students as well as ALPHA KAPPA ALPHA SORORITY, INC.- DELTA IOTA Chapter Members. SELECTION CRITERIA Must be a full-time college student at Cheyney University. Must be going into their 2 nd, 3 rd, or 4 th year. Must demonstrate financial need. Must have at least a 2.7 GPA. Have leadership experience. AWARD AMOUNT Three (3) $1,000 scholarships will be awarded to a 2 nd year, 3 rd year, and 4 th year student. Scholarship awards may be applied to primarily tuition, books and fees. APPLICATION SUBMISSION INSTRUCTIONS INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED. Please answer all questions, attach requested documents and make sure the application is signed by applicant and/or parent/guardian. If a question does not apply to you, please mark N/A. A Completed Application Includes: (Please check the boxes to indicate the attachments you have submitted. If an attachment is not applicable to you, please mark N/A next to the check box) Attachment A Copy of your Fall 2014 and Spring 2015 transcript Attachment B Copy of your most recent school bill. Attachment C Resume of Leadership Experience Attachment D Essay Attachment E Recommendation Form (provided with the application) must be completed and placed in a sealed envelope by the person who completed the form and submitted with this application. Please mail your application and all required attachments in ONE envelope to: The Philadelphia Foundation 1234 Market Street, Suite 1800 Philadelphia, PA 19107 Alpha Kappa Alpha Sorority, Inc.- Delta Iota Chapter 50 th Anniversary Scholarship Page 1 of 6
ALPHA KAPPA ALPHA SORORITY, INC.- DELTA IOTA CHAPTER 50 TH ANNIVERSARY SCHOLARSHIP APPLICATION APPLICANT INFORMATION Please print or type Name Last First Middle Permanent Address _ Street _ City County State Zip Telephone ( ) Email: Please print clearly Date of birth Gender: Student ID Number: FAMILY INFORMATION Please circle relationship Father/stepfather/guardian Address Street City State Zip Mother/stepmother/guardian Address Street City State Zip Number of siblings financially dependent on parent(s)/guardian Total number of family members If you are an independent student: Marital Status: Single Married Divorced Number of dependents: Annual Family Income: (Adjusted Gross Income) Under $25,000 $25,000 - $35,000 $35,000- $45,000 $45,000 - $55,000 $55,000 - $75,000 Over $75,000 COLLEGE/UNIVERSITY INFORMATION Please attach: A copy of your college transcript (Attachment A ) Institution for which aid is requested Street _ City County State Zip Major: Degree Sought Please give your GPA: Expected graduation date: Alpha Kappa Alpha Sorority, Inc.- Delta Iota Chapter 50 th Anniversary Scholarship Page 2 of 6
FINANCIAL AID INFORMATION Cost of Education per year: Please attach: Most recent school bill (Attachment B ) EXPENSES Amount Total Tuition and Fees Room and Board Books and Supplies Transportation _ $ TOTAL EXPENSES $ (A) INCOME NAME OF GRANT OR SCHOLARSHIP Federal, State & Other Awards (List loans and work study in Loan section below) College Grants & Scholarships (List loans and work study in (Loan section below) TOTAL GRANTS & SCHOLARSHIPS Estimated Family Contribution from Student Aid Report (SAR) TOTAL INCOME (Item B plus Item C) FINANICAL NEED (Item A minus Item D) (B) (C) (D) (E) LOANS AND EMPLOYMENT NAME OF SOURCE TOTAL LOANS & EMPLOYMENT Financial information is confidential for review only by the members of the Advisory Committee and The Philadelphia Foundation. Alpha Kappa Alpha Sorority, Inc.- Delta Iota Chapter 50 th Anniversary Scholarship Page 3 of 6
LEADERSHIP EXPERIENCE (Attachment C ): NOTE TO STUDENT: In completing this section, please list all your extra-curricular activities. It is important that you indicate all work experience, community activities, special projects, and other involvements/memberships which would aid the committee in determining leadership qualities. Please attach your answers on a separate sheet. 1. HIGH SCHOOL/COLLEGE EXTRA-CURRICULAR ACTIVITIES: Please note and give a brief description of any and all activities in which you currently participate. (E.g. Sports, Student Government Clubs, Publications, Committees, Special Projects, etc.) 2. ACTIVITIES OUTSIDE OF SCHOOL: Please give a brief description of all activities outside of school of which you were a part. (e.g. Social Clubs, Religious Activities, Hobbies, Boy/Girl Scouts, Etc.) 3. WORK ACTIVITIES: If you have done any volunteer work and/or held a paid position during high school or college, list and briefly describe your involvement(s). Include: title, responsibilities, starting/ending dates, and number of hours per week.*please distinguish between paid and volunteer positions. Essay (Attachment D ) This essay should be (2) typewritten double-spaced pages and must include information that will answer the following question: 1. How do you plan to distinguish yourself as a leader in the future? Please attach (1) double-spaced page statement describing any additional information you would like us to know about you including any unusual personal, financial, or family circumstances that warrant any special attention by the selection committee. CERTIFICATION AND SIGNATURES I, (we) certify that the information on this form is true and compete to the best of my (our) knowledge. If asked by any authorized official of The Philadelphia Foundation, I (we) agree to give the documentation for information given on this form. I (we) realize that failure to comply with a request for additional information may prevent the applicant from receiving any aid. I also grant The Philadelphia Foundation permission to use my photograph and/or selected quotes on their website and in future publications. Applicant signature Date Parent signature Date Send completed application and all required attachments together in ONE envelope to: The Philadelphia Foundation 1234 Market Street, Suite 1800 Philadelphia, PA 19107 Please E-mail any questions to scholarships@philafound.org APPLICATIONS MUST BE RECEIVED BY THE FOUNDATION BY MONDAY, JULY 6 TH. LATE APPLICATIONS WILL NOT BE CONSIDERED. Alpha Kappa Alpha Sorority, Inc.- Delta Iota Chapter 50 th Anniversary Scholarship Page 4 of 6
Attachment E The Alpha Kappa Alpha Sorority, Inc.- Delta Iota Chapter 50 th Anniversary Scholarship Scholarship Recommendation Form Recommendation form must be completed and placed in a sealed envelope by the person who completed the form. Please answer all of the questions listed on form. The sealed envelope should be submitted along with the application. Recommendations must be someone not related to you. (Ex. Professor, Counselor, Spiritual Leader, Employer ) Applicant s Name: Print Date: Applicant s Signature: _ Note: Signature grants permission to send information 1. In what context and for how long have you known the applicant? 2. Please share what you know about the applicant's circumstances and adversity by providing as much detail as possible. 3. Please share information about the applicant s accomplishments and future goals that would demonstrate the characteristics on which this scholarship is based. Alpha Kappa Alpha Sorority, Inc.- Delta Iota Chapter 50 th Anniversary Scholarship Page 5 of 6
4. Please share any other information you deem relevant. Name: Title: Signature: _ Date: Telephone: _ May we contact you if we have any further questions? Yes No Recommendations must be postmarked by MONDAY JULY 6, 2015. Please mail to: The Philadelphia Foundation Attn: Sylvia T. Spivey 1234 Market Street, Suite 1800 Philadelphia, PA 19107 Contact: Sylvia T. Spivey, Development and Scholarship Manager sspivey@philafound.org (215) 863-8121 Alpha Kappa Alpha Sorority, Inc.- Delta Iota Chapter 50 th Anniversary Scholarship Page 6 of 6