Eta Mu Lambda Chapter of Alpha Phi Alpha Fraternity, Inc. Scholarship Program 2017

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Eta Mu Lambda Chapter of Alpha Phi Alpha Fraternity, Inc. Scholarship Program 2017 1. DEADLINE for scholarship applications is May 1, 2017, 5:00 p.m. (No exceptions). 2. Refer to criteria below for eligibility requirements. 3. Refer to application process below for a list of the supporting documents needed (i.e., reference forms, evidence of GPA, etc.) Incomplete applications will not be considered. 4. If any question does not apply to you in this application please put N/A in the space. 5. Type or print legibly. Illegible applications will be returned to you. You may also download a fillable copy of the application online at www.etamulambda.org 6. You will be notified by mail in early June regarding the status of your application. 7. If you have any questions about the application, please contact the Foundation office at scholarship@etamulambda.org NOTE: Scholarship funds will be awarded to the student upon evidence of registration in an accredited post-secondary institution. Purpose: To Provide scholarships to two (2) deserving Gaston and Cleveland county high school graduating seniors interested in or intending to pursue post-high school course of study at either college/university or other postsecondary educational institution. Award Components: Two (2) scholarships awarded to two (2) students selected by the Eta Mu Lambda Education Foundation Scholarship Committee. Awards will be disbursed in these increments: two nonrenewable $500 dollar awards dispersed in one award. Criteria: 1. Applicant must be a Gaston, Cleveland or Lincoln county residents. 2. Applicant must be a graduating high school senior in the year of the award. 3. Applicant must demonstrate positive-impact involvement in the complete sense consistent with capacity and circumstances and/or significant improvement/success in scholarship and community involvement, determined through letters of recommendation. Application Process: Applicant must submit the following items: 1. Completed application form (if handwritten, please print legibly). 2. Letter of application addressed to the Scholarship Committee. The letter should contain a brief explanation of career goals and biographical (background) information. 3. Three (3) letters of recommendations from choice of high school teachers, administrators, counselors, employers, or individual with significant knowledge of applicant s experience and involvement. 4. An official and recent high school transcript with cumulative grade point average and a class standing/rank. 5. Personal Essay. In your essay, please answer the question on the enclosed essay form. Besides earning a degree, what do you wish to gain by attending college? (250 word minimum) Deadline for the application is May 1, 2017. Applications postmarked after this date will not be considered. Please mail OR submit application via email to: Scholarship Program Eta Mu Lambda Chapter of Alpha Phi Alpha Fraternity, Inc. ATTN: Scholarship Committee PO Box 141 Gastonia, NC 28053 scholarship@etamulambda.org 1

The Eta Mu Lambda Chapter of Alpha Phi Alpha Fraternity, Inc. Scholarship Application 2017 Please type or print your answers. If application is illegible it will be returned to you. 1. Last Name: First Name: 2. Mailing Address:: Street: City: State: ZIP: 3. Daytime Telephone Number: ( ) 4. Date of Birth: Month Day Year 5. Current High School: Number of years attended: 6. I will be attending the following school in the Fall of 2017: Proof of acceptance or current student enrollment from the above school is required prior to receipt of funds. 7. I will be entering the above-mentioned school as a: (Check one) Freshman Sophomore 8. Grade Point Average (GPA): (On a 4.0 scale) Attach proof of GPA. Your most recent official school transcript required. 9. ACT Score: Or SAT Score: A copy of your ACT or SAT score sheet on official high school transcript is required. 10. Name & address of parent or legal guardian: Name Street: City: State: ZIP: 11. Home phone of parent or legal guardian: Name and city of other high schools attended: Number of years attended: 12. List the name of any college you have attended. Year Began Year Ended Year Graduated (If applicable) A. B. C. 13. What specialty/major do you plan to major in as you continue your education? Type of Degree Received (If applicable) 2

14. List expenses you expect to incur per semester or quarter: (Approximate figures acceptable). A. Tuition: Amount: $ B. Books: Amount: $ C. Room & Board: Amount: $ D. Other expenses: Amount: $ Describe below under comments E. Other expenses: Amount: $ Comments: 15. List other financial assistance you will receive per semester or quarter: A. Personal: Amount: $ B. Other Scholarship(s): Amount: $ Describe below under comments C. Grants: Amount: $ C. Student Loan(s): Amount: $ D. Other Financial Resources: Amount: $ Comments: Use an additional sheet if you need more room to list financial information requested in items 14 & 15. 16. What are your educational and professional goals and objectives? 17. List your academic honors, awards and membership activities while in high school or college: 3

18. List your community service activities, hobbies, outside interests, and extracurricular activities: 19. Personal Essay Please answer the following question: Besides earning a degree, what do you wish to gain by attending college? Submit your response on the last sheet provided with this application. 20. A. The following items must be attached to this application in order for the application to qualify to be reviewed by the scholarship committee. B. Your application will be returned to you if these items are not attached to this application. (No exceptions.) C. Check YES or NO to be sure you have attached each item as required. YES NO Three (3) reference forms. Return these completed forms in a sealed envelope from your teachers or professors. YES NO Proof of college acceptance or current student enrollment. A letter of college acceptance or program acceptance is required for receipt of funds. YES NO Most recent official high school or official college transcript. Photocopies of your transcript are not acceptable. YES NO Personal Essay. Besides earning a degree, what do you wish to gain by attending college? STATEMENT OF ACCURACY I hereby affirm that all the above stated information provided by me is true and correct to the best of my knowledge. I also consent that my picture may be taken and used for any purpose deemed necessary to promote the Foundation s scholarship program. I hereby understand that if chosen as a scholarship winner, according to Eta Mu Lambda Chapter of Alpha Phi Alpha Fraternity, Inc. Scholarship policy, I must provide evidence of enrollment/registration at the post-secondary institution of my choice before scholarship funds can be awarded. Signature of scholarship applicant: Date: REMEMBER The deadline for this application to be received by the chapter is May 1, 2017, 5:00 p.m. No exceptions! 4

The Eta Mu Lambda Chapter of Alpha Phi Alpha Fraternity, Inc. Scholarship Application 2017 Personal Essay (250 word minimum) Besides earning a degree, what do you wish to gain by attending college? 5