20 atson scholarship program...

Dear Applicant:

The Lynchburg Alumnae Chapter of Delta Sigma Theta Sorority, Inc. is committed to helping young

the Lynchburg Alumnae Scholarship Program, you must:

1. a high school senior attending a public, private, charter or parochial high school.

2. Have an overall grade point average of 2. (based on a 4.0 non-weighted scale).

3. Intend to enroll in a full-time program at an accredited college, university, or institution ofequivalent accreditation during the academic year.

4. Submit an application by , signed in ink, by you and your parent/guardian and include:

mailed separately);

service , leadership activities, college and career goals.

scholarship.

.

5. Participate in an interview as part of the selection process

6.

7. Provide veri�cation of college enrollment before you can receive

8.

9.

DELTA SIGMA THETA SORORITY, INC.

LYNCHBURG ALUMNAE CHAPTER

.

20 ATSON SCHOLARSHIP PROGRAM OVERVIEW

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Use this checklist to make sure that you have submitted all required materials to receive consideration for a scholarship. Incomplete applications will not be considered. Your application must include the following documents:

A computer generated application – no hand written applications will be accepted

Your signature, in ink, at the end of the application

Your parent or guardian’s signature, in ink, at the end of the application

Media Release and Photography Form signed, in ink, by a parent or guardian

An o�cial, signed high school transcript in a separate sealed envelope (parchment transcripts are permitted); does not have to be mailed separately

Two (2) letters of recommendation from any of the following persons (no more than one per category ) dated no earlier than September 1, 2019:

• Community Leader• High School Educator• High School Administrator• Minister

• Organizational Sponsor• Employer• Volunteer Coordinator



LYNCHBURG ALUMNAE CHAPTER • P.O. BOX 11894 • LYNCHBURG, VIRGINIA 24506-1894

2020 ELAINE C. WATSON SCHOLARSHIP APPLICATION CHECKLIST

All letters must include the contact information of the person providing the recommendation and must be signed in ink. Recommendations from family members are not acceptable. It is suggested that you ask the people who are writing your recommendations to comment upon: (1) the length of time they have known you; (2) your personal qualities, character, leadership abilities, and/or any special attributes, and (3) why they believe you will succeed at the college/university level.

A one-page essay highlighting your need for the Scholarship Award, your community service involvement, leadership activities, and college and career goals must be (computer generated, size 12 Times New Roman font, double-spaced, and one-inch margins)

Submit Completed Application to:Lynchburg Alumnae Chapter • Delta Sigma Theta Sorority, Inc.

Attn: Scholarship Committee • P.O. Box 11894 • Lynchburg, VA 24506-1894

ALL APPLICATIONS MUST BE MAILED AND POSTMARKED BY March 16, 2020. No hand written or hand delivered applications will be accepted.



2020 ELAINE C. WATSON SCHOLARSHIP APPLICATION

(1) Applicant Information

(2) Parent/Guardian Information

High School

College/University and Major


Provide all information requested below.

FIRST NAME

STREET ADDRESS

CITY STATE ZIP

HOME PHONE MOBILE PHONE E-MAIL ADDRESS

DATE OF BIRTH (Month/Day/Year) PLACE OF BIRTH (City and State)

HIGH SCHOOL ATTENDING OVERALL GPA EXPECTED GRADUATION DATEGRADE

ADDRESS CITY STATE ZIP

CITY STATE ZIP

PREFERRED COLLEGE/UNIVERSITY

INTENDED MAJOR/FIELD OF STUDY

LOCATION (City and State)

INTENDED MINOR/FIELD OF STUDY

NAME OF MOTHER/GUARDIAN

ADDRESS

MOTHER’S WORK PHONE MOTHER’S MOBILE PHONE

MOTHER’S OCCUPATION MOTHER’S EMPLOYER

CITY STATE ZIP

NAME OF FATHER/GUARDIAN

ADDRESS

FATHER’S WORK PHONE FATHER’S MOBILE PHONE

FATHER’S OCCUPATION FATHER’S EMPLOYER

MIDDLE NAME LAST NAME GENDER

(6) Financial Awards and Scholarship

(5) Colleges and Universities

(4) Work Experience

Use this checklist to make sure that you have submitted all required materials to receive consideration for the scholarship selected. Incomplete applications will not be considered. Your application must include the following documents:

A computer generated application – no hand written applications will be accepted

Your signature, in ink, at the end of the application

Your parent or guardian’s signature, in ink, at the end of the application

Media Release and Photography Form signed, in ink, by a parent or guardian

An o�cial, signed high school transcript in a separate sealed envelope (parchment transcripts are permitted); does not have to be mailed separately

Two (2) letters of recommendation from any of the following persons (no more than one per category) dated no earlier than September 1, 2017:

• High school teacher • Organizational sponsor • Community leader • Minister • High school principal • Employer • High school counselor • Volunteer coordinator

All letters must include the contact information of the person providing the recommendation and must be signed in ink. Recommendations from family members in the categories above will not be accepted. It is suggested that you ask the people who are writing your recommendations to comment upon: (1) the length of time they have known you; (2) your personal qualities, character, leadership abilities, and/or any special attributes; and (3) why they believe you have the perseverance to succeed at the college/university level.

A one-page essay highlighting your need for the Scholarship Award, your community service, leadership activities, and college and career goals (computer generated, size 12 Times New

Roman font, double-spaced, one-inch margins)




(3) Financial Need

ALL APPLICATIONS MUST BE MAILED AND POSTMARKED BY MARCH 28, 2020.No hand written or hand delivered applications will be accepted.


NUMBER OF DEPENDENT CHILDREN IN FAMILY

TOTAL AMOUNT AWARDED

NUMBER OF DEPENDENT CHILDREN CURRENTLY ATTENDING A COLLEGE/UNIVERSITY

EMPLOYER/ORGANIZATION DATE OF EMPLOYMENT/SERVICE POSITION HELD

Check the box below that best describes your family’s combined gross income. Income should include employment, SSI, FIA, alimony, child support, disability, etc.

$0 - $14,999

$15,000 - $29,999

$30,000 - $49,999

$50,000 - $74,999

$75,000 - $99,999

$100,00 or More

(1)

(2)(3)

(4)(5)

SCHOLARSHIP, LOAN, GRANT, or AWARDFOR WHICH YOU APPLIED

AWARDING ORGANIZATION AMOUNT AWARDED

(1)

(2)(3)

(4)

NAME OF SCHOOL TO WHICH YOU APPLIED CITY/STATE STATUS OF APPLICATION

(1)

(2)(3)

(4)(5)

(9) Other

(8) Extra-Curricular/Community Service/Volunteer Experience/Activities(e.g., school, religious, social groups)




(7) Honors and Awards (e.g., academic, athletic, community, and/or school awards)



AWARD SOURCE OF AWARD REASON(S) FOR AWARD

(1)

(2)(3)

(4)

(5)

NAME OF GROUP/ACTIVITY/SERVICE GRADE (Check Boxes That Apply) LEADERSHIP POSITION(S) HELD

(1)

(2)(3)

(4)

(5)(6)

(7)(8)(9)(10)

9 10 11 12

Indicate any additional information not previously shared in this application that you feel the Lynchburg Alumnae Chapter Scholarship Committee should consider in evaluating your need and eligibility for this scholarship. Do not use this space for the required student essay highlighting community service, leadership activities, and college and career goals.





SIGNATURE OF APPLICANT

SIGNATURE OF APPLICANT’S PARENT OR GUARDIAN

DATE

DATE

SIGNATURE OF APPLICANT’S PARENT OR GUARDIAN DATE

We hereby certify that the information provided in this application is to the best of our knowledge, true and correct. We have not knowingly withheld any facts or circumstances that could otherwise jeopardize consideration of this application. We understand this application packet will be kept confidential. All materials submitted become the final property of the Lynchburg Alumnae Chapter of Delta Sigma Theta Sorority, Inc.

Media Release and Photography Form

I understand that my child may be photographed in connection with his/her application for the scholarship awards offered by the Lynchburg Alumnae Chapter of Delta Sigma Theta Sorority, Inc. (the “Chapter”). I give permission for the Chapter to publish on the Internet or media still photographs (“Images”) that may be taken of my child without payment or any consideration and without notifying me. I understand and agree that these images will become the property of the Chapter, which shall have complete ownership of the images. I hereby irrevocably authorize the Chapter to publish or distribute these images for the purpose of publicizing the Chapter’s scholarship program or for any other lawful purpose. In addition, I waive any right to inspect or approve the �nished product wherein my child’s likeness appears. Additionally, I waive any rights to royalties or other compensation arising out of or related to the use of the images.

I hereby hold harmless and release and forever discharge the Chapter and any of its Officers and Members; Delta Sigma Theta Sorority, Incorporated; its officers; National Executive Board; Employees; Members; Representatives; Agents; and Assigns from any and all claims, costs, suits, actions, judgments, and expenses which my child, his/her heirs, representatives, executors, administrators, or any other persons acting on his/her behalf, have or may have by reason of the use of the images. This release specifically includes, without limitation, a complete release and discharge of any liability by virtue of any editing, distortion, alteration, or optical illusion, whether intentional or otherwise, that may occur or be produced in the taking of or editing of said images, unless it can be shown that such was maliciously caused, produced and published solely for the purpose of subjecting my child to conspicuous ridicule, scandal, reproach, scorn and indignity.

20 atson scholarship program...

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