Alpha Epsilon Delta The Health Preprofessional Honor Society

Scholarship Application 2019

Applicants are responsible for Student Section providing all information requested on the Application Form. First Name Permanent Address Additional material will not be considered. Incomplete application forms Middle Name City will not be accepted.

Your completed application packet must include the following: Last Name State

• This form must be submitted as is and must be typed (the form is fillable);any alteration will invalidate your Email Zip Code application.

• Application must be signed by either the chapter advisor or the chapter Birth Date (MM/YY) Cell Number president. We will accept handwritten signatures or electronic signatures.

• Official or unofficial transcript(s) from all undergraduate work. Chapter/Institution Section

• Letter of support from two of the Chapter (State, Greek) Undergraduate Institution following: Chapter advisor, chapter officer, nationally registered member or honorary member.

• Digital high quality photograph for AED National ID Region President of Undergraduate Institution publication in our Society’s journal, “The Scalpel” (email to [email protected]) subject line: Scholarship Photo Dean of College/School Chapter Advisor

Your complete application package must Dean’s Mailing Address Advisor Mailing Address be postmarked no later than April 30, 2019 of your senior year and mailed to the following address: Alpha Epsilon Delta National Office TCU Box 298810 Advisor Phone Advisor Email Fort Worth, TX 76129

Failure to include these items will Academic Major Degree invalidate your application.

More than one application will be accepted from each chapter. Overall GPA Science (BCPM) GPA

Eligibility for any scholarship is dependent on acceptance and attendance at a med- ical, dental or other health care related Health Professional School you will be attending professional school. Scholarship applicants will be notified of the results in Fall 2019.

Page 1 of 3 Alpha Epsilon Delta The Health Preprofessional Honor Society

Scholarship Form

Applicants are responsible for providing all information requested List below scholastic honors, awards, and recognitions you have re- on the Application Form. ceived, i.e., scholarships, Dean’s List, Honor Societies, since high school. 10 listings maximum Additional material will not be considered. 1. Incomplete application forms will not be accepted. 2. Your completed application packet must include the following: 3.

• This form must be submitted as is and 4. must be typed (the form is fillable);any alteration will invalidate your 5. application.

• Application must be signed by either 6. the chapter advisor or the chapter president. We will accept handwritten 7. signatures or electronic signatures. 8. • Official or unofficial transcript(s) from all undergraduate work. 9. • Letter of support from two of the following: Chapter advisor, chapter 10. officer, nationally registered member or honorary member.

• Digital high quality photograph for publication in our Society’s journal, “The List below extracurricular activities, i.e., student offices held, society Scalpel” membership and activities, athletic activities, since high school. 10 listings (email to [email protected]) maximum. Do not repeat those listed in the previous section. subject line: Scholarship Photo 1. Your complete application package must be postmarked no later than April 30, 2019 2. of your senior year and mailed to the following address: 3. Alpha Epsilon Delta National Office 4. TCU Box 298810 Fort Worth, TX 76129 5. 6. Failure to include these items will invalidate your application. 7. More than one application will be accepted from each chapter. 8. Eligibility for any scholarship is dependent 9. on acceptance and attendance at a med- ical, dental or other health care related professional school. Scholarship applicants 10. will be notified of the results in the Fall 2019.

Page 2 of 3 Alpha Epsilon Delta The Health Preprofessional Honor Society

Scholarship Form

Provide a typed statement (minimum 10-point font size) of your college and premedical activities focusing on AED contributions, including offices held, committee and convention participation. Note: Only the information provided in the space below will be considered!

Signature Section

Student Signature

Advisor or Chapter President Signature

Page 3 of 3