2017 SCHOLARSHIP APPLICATION FORM

(Please Type or Print)

Name: ______

Address: ______

Telephone: Home: (Area Code) ______Cell Phone: (Area Code) ______

Email: ______

Parent/Guardian Information

Mother: Father:

Name: ______

Address: ______

Employment: ______

Education: ______

Extracurricular Activities (school based) (may attach one additional page): ______

Volunteer Activities (community) (may attach one additional page): ______

Requirements:  Be a graduating senior from a Columbia area high school;  Complete the scholarship application;  Provide a transcript indicating that the student has a 2.5 G.P.A. or higher;  Attach a copy of acceptance letter to a two or four-year degree program;  Provide a letter of recommendation from a teacher;  Provide a letter of recommendation from a member of the community; and  Type an essay (3-5 pages) describing “Achieving My Dreams Through College”.  Sign and mail you application package to the address below.

You may submit your application and the other required documents (transcript, letter of acceptance, letter of recommendations from teacher and member of community and essay) to:

Scholarship Committee Kappa Foundation of Columbia, SC Post Office Box 3313 Columbia, SC 29203 Deadline: Applications must be postmarked by May 12, 2017.

You are applying for a $1000 scholarship sponsored by the Kappa Foundation of Columbia, SC. The foundation will award at least 3 scholarships in school year 2017. The scholarships are available to graduating seniors who plan to enter a two or four- year degree program in 2017. Scholarship funds will be paid directly to the college or university that you attend.

You will be notified only if you are awarded a scholarship. If you accept a scholarship award you agree to permit the Kappa Foundation of Columbia (SC) to post your photo on its website and utilize your photo(s) for future publication(s) to promote the foundation:

Student Signature: ______

Student Name (print)______

Date: ______

Scholarship Committee Kappa Foundation of Columbia, SC Post Office Box 3313 Columbia, SC 29203 Deadline: Applications must be postmarked by May 12, 2017.