Order of Ahepa

ORDER OF AHEPA and DAUGHTERS OF PENELOPECAPITAL DISTRICT #3COLLEGE SCHOLARSHIPAPPLICATIONACADEMIC YEAR 2007______WASHINGTON, DC VIRGINIA MARYLAND NORTH CAROLINA WEST VIRGINIA ______Capital District 3 Scholarship Application Form (Rev. 12/04/2006) 2 of 9 Dear Applicant:Please read the following instructions thoroughly before completing this application. Your application begins on PAGE 4.MAKE SURE ALL necessary documents are included with your application:A. Transcripts B. SAT Scores (High School and College Freshman only) GPA minimum 2.5. C. Copies of Certificates (If any) D. Written Essay – a 300 word essay is required. E. Any other documents you wish to have reviewed with your application.DO:  MAKE SURE your application is post marked no later than APRIL 1, 2007.  MAKE SURE you have ALL required Signatures. If your Chapter President or Secretary is not available, have the Vice President sign the Chapter certification.  MAKE SURE you mail the application package to the mailing address stated on PAGE (3).  MAKE SURE you are a child (not niece, nephew, grandchild, cousin, etc.) of either an AHEPAN or a Daughter of Penelope.  MAKE SURE your sponsoring Chapter (Chapter of the President and Vice President) must be in good standing. This means the Chapter must have paid all of its District and National per capita dues by 12/31/2006 for all of its members.  To confirm eligibility contact your sponsoring Chapter or the District Marshall.  MAKE SURE you have a GPA of at least 2.5.  MAKE SURE you submit pages 4, 5, and 6.  MAKE SURE you submit pages 4, 5, 6, 7 and 8 if you require financial aid.  MAKE SURE you submit a recent passport size photo.DON’T:  Submit an application if you are a graduate student, post graduate student or are in Law or Medical School.  Submit an application unless you are a child of either an AHEPAN or a Daughter of Penelope.  Return the cover page or these instruction sheets (pages 1-3).PAY CLOSE ATTENTION TO THE FOLLOWING:It is very important that you score as high as possible on your essay. As you can see below, the essay carries 30 possible points. The essay must be 300 words in length.  The essay must have a HEADING or TITLE  Your essay must address the topic “The Value of a College Education.”  Check your grammar and spelling.  Your essay must be typed – one and a half spacing preferred. o Use standard type without italics, bolding or graphics. o Times Roman or Arial fonts are preferred. o 10 or 12 point size  Use white paper. Capital District 3 Scholarship Application Form (Rev. 12/04/2006) 3 of 9 SCHOLARSHIP APPLICATION SCORING CRITERIACOLLEGE UPPER CLASS:Grade Point Average possible 40 points Dean’s List possible 10 points Honors/Extra Curricular Activity possible 10 points Part Time Employment possible 10 points Essay possible 30 pointsTotal 100 points HIGH SCHOOL SENIOR OR COLLEGE FRESHMAN:SAT score possible 10 points Class Standing Top percent of Class possible 10 points Grade Point Average possible 20 points National Honor Society possible 10 points Honor/Extra Curricular Activities possible 20 points Essay possible 30 pointsTotal 100 pointsPLEASE MAIL THE COMPLETED APPLICATION & SUPPORTING DATA TO CAPITAL DISTRICT NO. 3 MARSHALL:Larry Odzak 204 Pineview Road Durham, NC 27707-2846 Phone 919-489-8042 Email: [email protected](Do not hesitate to call or email if you have any questions.)Capital District 3 Scholarship Application Form (Rev. 12/04/2006) 4 of 9 Scholastic Achievement Scholarship Application (TO BE COMPLETED BY ALL APPLICANTS). The entire application package becomes the property of the Scholarship Foundation and will not be returned. CHECK ONLY ONE BOX BELOW AND PROCEED ACCORDINGLY. □ SCHOLASTIC ACHIEVEMENT (Complete pages 4, 5, and 6) □ FINANCIAL NEED (Complete pages 4, 5, 6, 7 and 8) 1. Name of Applicant ______(Last, First, MI)2. Home Address ______(Mailing Address)3. Telephone Number ( ) _____-______4. Date of Birth ______5. Social Security Number ______-____-______6. Name of the College or University you will be attending in the Fall for Undergraduate Studies: ____________City StateName of College Registrar______7. To be eligible you must have a grade point average of at least 2.5 and check one of the following:□ Be a son or daughter of a member in good standing of either the ORDER OF AHEPA or The DAUGHTERS OF PENELOPE in District #3.□ Be a son or daughter of a deceased member of either the ORDER OF AHEPA or The DAUGHTERS OF PENELOPE in District #3.□ Be a member in good standing of the ORDER OF AHEPA, DAUGHTERS OF PENELOPE, SONS OF PERICLES, or MAIDS OF ATHENA.8. Credentials required: (Attach to Application)High School Senior: College Freshman: College Upper Classman: High School Transcript High School Transcript College Transcript Class Rank Class Rank Grade Point Average Grade Point Average Grade Point Average SAT Scores SAT Scores College Transcript & Grade Point AverageCapital District 3 Scholarship Application Form (Rev. 12/04/2006) 5 of 9 Scholastic Achievement Application (cont.)9. List all honors, awards (e.g., National Honor Society, Dean’s List (Number of Awards), extracurricular activities, etc.).__________________________________________10. List employment history (part and full time).________________________11. All applicants must attach a three hundred (300) word essay on: “The Value of a College Education.”12. All applicants must submit a recent photo per the instructions in the space below.ATTACH A RECENT PASSPORT SIZE PHOTO OF YOURSELF HEREAPPLICANT CERTIFICATION:Everything I have submitted is true to the best of my knowledge and belief.______STUDENT SIGNATURE DATE ______PARENT/GUARDIAN SIGNATURE DATE Capital District 3 Scholarship Application Form (Rev. 12/04/2006) 6 of 9 CHAPTER CERTIFICATION (To be completed by the sponsoring AHEPA or DOP chapter) Our Chapter hereby submits the application of:______Name of ApplicantThis application appears to meet all of the eligibility criteria established and we hereby request it be reviewed for consideration. This applicant or his/her parent is a member in good standing at the time of the application.CHAPTER PRESIDENT CHAPTER VICE PRESIDENT/SECRETARY ______Print Name Print Name ______Signature Signature ______Chapter Name & Number Chapter Name & Number ______Date Date IMPORTANTCHAPTERS WHO HAVE PAID BOTH THEIR NATIONAL AND DISTRICT PER CAPITA TAX IN FULL ARE ELIGIBLE TO SUBMIT APPLICANTS. (GOOD STANDING MEANS A CHAPTER IS PAID THROUGH DECEMBER 31, 2006.)NO SCHOLARSHIP APPPLICANT WILL BE CONSIDERED UNLESS THE COMPLETED APPLICATION, REQUIRED CREDENTIALS AND THE 300 WORD ESSAY IS POST MARKED NO LATER APRIL 1, 2007.PLEASE MAIL THE COMPLETED APPLICATION & SUPPORTING DATA TO CAPITAL DISTRICT NO. 3 MARSHALL:Larry Odzak, 204 Pineview Road Durham, NC. 27707-2846 Email: [email protected]Capital District 3 Scholarship Application Form (Rev. 12/04/2006) 7 of 9 Financial Need Scholarship Application Please complete the following questionnaire if you are applying on the basis of financial need. Make sure to answer all questions. (Use N/A if the question does not apply.) (PLEASE PRINT)Name______SSAN _____-____-_____ Date: ______20___Address: ______City: ______State: ______Zip ______Do you live with your parents? □ Yes □ No Are you a U.S. Citizen? □ Yes □ No If not a permanent resident, indicate Alien Registration Number: ______If No, explain status/ type of visa: ______NOTE: IF YOU ANSWERED “NO” TO ALL OF THE ABOVE, CONTACT THE DISTRICT MARSHALLCollege Major: ______Anticipated Graduation Date: ______List all colleges/universities you have attended, whether you received financial aid or not. Also, list credit hours earned.INSTITUTION CITY & STATE DATES ATTENDED CREDIT HOURS: ______Have you applied for financial aid through the FAFSA? □ Yes □ No If YES, what type of aid are you receiving or do you expect to receive? □ Pell Grant □ SEOG □ Work Study □ Stafford Loan □ Other Have you applied for financial aid at your college/university? □ Yes □ No If YES, please explain what aid are you receiving or expecting to receive? ______Do you anticipate receiving any outside scholarships? □ Yes □ No If YES, source: ______Amount: ______Your parents’ current martial status: □ Married □ Separated □ Divorced □ WidowedCapital District 3 Scholarship Application Form (Rev. 12/04/2006) 8 of 9 Financial Need Application (cont.)Number in your parents’ household in 2006 (Include yourself and parents. Do not include your parents, other children or any other person, unless they are claimed for tax purposes.): ______Student’s expected income for 2007 (Income earned from work by you): ______Other taxable income: ______Non-taxable income and benefits: ______Parents expected income in 2007:______Income earned from work by your father: ______Income earned from work by your mother: ______Other taxable income: ______Non-taxable income: ______Student’s cash, checking and saving accounts: ______Parents’ cash, checking and savings accounts: ______Other real estate and investments: Value: ______Debt: ______Business Value: ______Debt: ______Earned Value: ______Debt: ______Please list any circumstances, which will affect your financial situation during the academic year 2007.______APPLICANT CERTIFICATION:Everything I have submitted is true to the best of my knowledge and belief.______STUDENT SIGNATURE DATE ______PARENT/GUARDIAN SIGNATURE DATE Capital District 3 Scholarship Application Form (Rev. 12/04/2006) 9 of 9

Order of Ahepa

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