General Scholarship – North Harris County Alumnae Chapter of Delta Sigma Theta Sorority, Incorporated

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I. PERSONAL INFORMATION *

First

Middle

Last

Cell Phone Number *

Home Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Date of Birth *

Parent/Guardian's Name *

First

Last

Parent/Guardian’s Phone: *

Is your Parent/Guardian a member of Delta Sigma Theta Sorority, Inc.? *

II. ACADEMIC PROFILE *

Expected Date of Graduation: *

Cumulative GPA (indicate scale): *

Class Rank/Size: *

University/College you plan to attend: *

Proposed Major *

III(a). LETTER OF RECOMMENDATION #1 *

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Please submit two letters of recommendation from non-family members detailing your qualifications for the scholarship and community service involvement. One letter must come from a teacher or a counselor at your school for the current school year. The other letter may come from a school official, a community service supervisor, clergyman, or employer. Both letters must be on school/organization official letterhead, as well as signed (original signature) and dated. Electronic signatures will NOT be accepted.

III(b). LETTER OF RECOMMENDATION #2 *

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IV. HIGH SCHOOL ORGANIZATIONS *

Organization(s) and position(s) held - include length of participation (e.g. Vision Club, Vice President September 2022 – May 2024)

Community Service Activities *

Community Service Activities and position(s) held during high school - include length of participation (e.g. Mickey Leland Food Drive, monthly, January 2022 – May 2024)

Church Related Activities *

Church related activities and position(s) held during high school -include length of participation (e.g. Spring Church Altar Server, October 2022 – September 2024)

V. ACHIEVEMENTS & AWARDS *

Please list below any honors or awards you have received during high school, including year obtained (e.g. National Honor Society 2022, 2023, 2024)

VI. WORK EXPERIENCE *

Please share your work experiences during high school or N/A if none were held (e.g. Name of com-pany, year and position held)

VII. ESSAY: Delta Sigma Theta Sorority, Inc. serves its community under a five point programmatic thrust promoting: Economic Development, Educational Development, International Awareness and Involvement, Physical and Mental Health, and Political Awareness and Involvement. How do your future goals fall into any of these areas and how will receiving this scholarship help you achieve these goals? *

VIII. HEADSHOT *

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Please upload CURRENT headshot

VIII. AUTHENTICITY STATEMENT *

I hereby declare that all information contained in this application is truthful and accurate. I understand that misrepresentation of any information or the submission of inac-curate or incomplete information will result in disqualification to be considered for a scholarship.

This box MUST be checked in order for application to be considered.

VIII. CERTIFICATION STATEMENT *

If I am selected as a scholarship recipient, I agree to submit all necessary documentation (e.g. proof of enrollment/registration, etc.) for disbursement of funds during the Fall term of my Freshman year. I understand that failure to do so by the deadline date will forfeit my scholarship award.

This box MUST be checked in order for application to be considered.

VIII. AUTHORIZATION STATEMENT *

I understand that, should I receive the scholarship, my picture and/or name may appear on videotape, the sorority’s/chapter’s website, newspaper, or television. Furthermore, I agree to accept the decision of the NHCAC Scholarship Committee of Delta Sigma Theta Sorority, Incorporated.

This box MUST be checked in order for application to be considered.

X. OFFICIAL HIGH SCHOOL TRANSCRIPT *

I understand that my application is not complete until my OFFICIAL, SEALED HIGH SCHOOL TRANSCRIPT has been received by the Scholarship and Awards Committee of the North Harris County Alumnae Chapter of Delta Sigma Theta Sorority, Inc.

My typed signature below serves as acknowledgement that the information I provided on this form is true and accurate. *

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