Alumna Application 2012 word by oM4Qk3H

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									                      ALPHA XI DELTA SCHOLARSHIP APPLICATION

                 DEADLINE: All materials must be postmarked no later than
                                              March 15, 2012
                                  Alpha Xi Delta Foundation, Attn: Claressa Basile
     8702 Founders Road • Indianapolis, IN 46268 • p. 317.872.3500 • f. 317.872.2947 • cbasile@alphaxidelta.org


Foundation scholarships are available to initiated members in good standing. Only completed
applications will be considered. A completed application includes the following:

    A four-page application form
    Personal Statement
    An official college/university transcript(s) from the registrar’s office
        Photocopies and faxed copies will not be accepted.
    Scholarship recommendation form
        This recommendation form should be completed by an Alpha Xi Delta alumna in
        good standing, preferably a volunteer or advisor.
    Letter of recommendation
        This recommendation should be from a current or former employer or
        college/university faculty member.

Suggestions

Watch the clock. Follow up with the registrar’s office and those completing recommendations
to ensure that all supporting materials arrive by the deadline.

Activities. Do not list high school activities. Please list Alpha Xi Delta involvement separately
from community activities, including philanthropy and service activities.

Don’t Assume. For activities and awards that are unique to your university, major or otherwise,
please provide a brief explanation. For example, it would be helpful for the person reviewing
your application to know that “Kappa Delta Pi is an honor society for education majors.”

Recommendations. Seek out those individuals who know you well. They will be in a better
position to address your strengths and contributions.

Submitting documentation. Try to send all items together to ensure they are postmarked by the
March 15 deadline. If items are not sent together, you may contact Claressa Basile at
cbasile@alphaxidelta.org to ensure all items have been received.
                 Alumna Scholarship Application
This form is to be used if the applicant is an alumna member on March 15, 2012. Alpha Xi
Delta Foundation scholarships are available to alumnae members returning to school who were
in good financial standing with their chapter as collegiate members. Amounts range from $500-
$2,000. Criteria will include Alpha Xi Delta and community involvement, academic
achievement, professional experience, the applicant’s goals, references, and financial need. The
applicant will be notified about the status of her application after June 1, 2012.

A completed application includes:
    completed four-page application form                         Must Be Postmarked By:
    official transcript(s) sent to the Alpha Xi Delta            MARCH 15, 2012
     Foundation from the registrar’s office of each
     college/university attended                                  MAIL, FAX or EMAIL to:
          a) Undergraduate                                        Alpha Xi Delta Foundation
          b) Current thru first semester or quarter               ATTN: Claressa Basile
              of the current academic year                        8702 Founders Road
    personal statement                                           Indianapolis, IN 46268
    recommendation form completed by an Alpha                    Fax: 317.872.2947
     Xi Delta alumna (preferably a volunteer or                   Email: cbasile@alphaxidelta.org
     advisor)
    letter of recommendation from a current or              Questions? Contact Alpha Xi Delta Foundation
                                                             at 317.872.3500 or cbasile@alphaxidelta.org.
     former employer or academician

How did you learn about this scholarship opportunity?


Name
        (Last)                            (First)                           (Middle/Maiden)


Mailing Address
                   (Address)                             (City)                        (State)   (Zip Code)


Phone                               Email
Chapter                              University
Date Initiated                     Number of Years as a Collegiate Chapter Member
Undergraduate Degree/Major
Undergrad Cumulative GPA/Scale                /          Undergrad Graduation Date
Marital Status                                           Number of Children
Have you applied to graduate school?                       Have you been accepted?
Applicant Name:


                                             Graduate Education
College/University
Degree Program/Major
Anticipated Graduation Date                                    Cumulative GPA/Scale                    /
Credit Hours Completed                 Estimated Credit Hours in 2012/2013
                                 Campus Studies         Online Studies


                                        FINANCIAL STATEMENT
                         Applications are held in confidence by the committee.
    Please review the financial statement example on the last page of application before completing.

                                             Financial Statement
                   Your estimated income and expenses for the 2012-2013 academic year
                        INCOME                                                              EXPENSES
                                                    Amount                                                     Amount
Employment                                                           Tuition & Fees
From your family (amount your family
                                                                     Room & Board
will contribute to your education)
Loans                                                                Books & Supplies
Scholarships, grants, awards                                         Undergraduate loan repayment
Spouse income                                                        Other expenses
Other income



                      TOTAL INCOME              $                                  TOTAL EXPENSES          $
                       Income from this scholarship may be taxable. Check with your tax consultant.



                                         PERSONAL STATEMENT
    On a separate sheet (use as many sheets as necessary), please respond to questions 1-5:
1. Work Experience – List all professional experience including internships.
2. What are your educational goals and career objectives?
3. What would you be able to accomplish if you received an Alpha Xi Delta Foundation
   scholarship that you would not otherwise be able to accomplish?
4. What does ’s “lifetime commitment” mean to you?
5. Describe special circumstances or financial need and the efforts you have made to help
   yourself financially.
Applicant Name:

                             COLLEGIATE & ALUMNAE INVOLVEMENT
List all collegiate and alumna offices (elected, appointed), committee activities/offices, volunteer activities, non-
academic awards and recognition related to Alpha Xi Delta.

Status: C = Collegiate; A = Alumna
Type of Office: E = Elected, A = Appointed;
                                                                                     Status       Type of
                                                                                                  Office
                                                                                    C      A     E A n/a          Year
Alpha Xi Delta    Office:
Service           Office:
                  Office:
                  Office:
                  Office:
                  Office:
                  Panhellenic Office:
                  Panhellenic Office:
                  Panhellenic Office:
                  Panhellenic Office:
                  Committee Chair:
                  Committee Chair:
                  Committee Chair:
                  Committee Chair:
                  Committee Chair:
                  Committee Member:
                  Committee Member:
                  Committee Member:
                  Committee Member:
                  Committee Member:
                  Activity:
                  Activity:
                  Activity:
                  Activity:
                  Activity:
                  Activity:
                  Award/Honor:
                  Award/Honor:
                  Award/Honor:
                  Other:
                  Other:
                  Other:

List all volunteer activities not related to Alpha Xi Delta.
                                                                                                                  Year
Community         Activity/Membership:
Activities        Activity/Membership:
                  Activity/Membership:
                  Activity/Membership:
                  Activity/Membership:
                  Activity/Membership:
                  Activity/Membership:
                  Activity/Membership:
                  Activity/Membership:
Applicant Name:

                       COLLEGIATE & ALUMNAE INVOLVEMENT (CONT.)
List all professional, academic, and community awards, honors and special recognitions. Please indicate if you have
previously received a scholarship from Alpha Xi Delta Foundation.

                                                                                                p
                                                                                              (Y/N)         Year
Awards, Honors,                                                                                No
and Special                                                                                    No
Recognition                                                                                    No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No
                                                                                               No


List all campus activities and include leadership responsibilities.
                                                                                     Type of Office
                                                                              Elected Appointed       n/a   Year
Campus            Office:
Activities        Office:
                  Office:
                  Office:
                  Office:
                  Committee Chair:
                  Committee Chair:
                  Committee Chair:
                  Committee Chair:
                  Committee Member:
                  Committee Member:
                  Committee Member:
                  Committee Member:
                  Committee Member:
                  Activity:
                  Activity:
                  Activity:
                  Activity:
                  Activity:
                  Award/Honor:
                  Award/Honor:
                  Award/Honor:
                  Award/Honor:
                  Other:
                 Other:
 SCHOLARSHIP
RECOMMENDATION FORM                                      This section to be completed by applicant:
to be completed by an                             Name_________________________________________
Alpha Xi Delta alumna
                                                  Address_______________________________________

Must Be Postmarked By: March 15, 2012             ______________________________________________

                                                  Phone_________________________________________

                                                  Email_________________________________________

Instructions: Please complete this form and return to the applicant in a sealed envelope with
your signature across the seal. This recommendation will remain strictly confidential. Your
thoroughness and care in providing this information requested are sincerely appreciated.

Capacity in which you have known the applicant: ____________________________________

Length of time you have known the applicant: _______________________________________

Based on your relationship with the applicant, please rate the following by circling the
appropriate response:
                                                                               Very
                                        Weak      Average        Strong                    Exceptional
                                                                              Strong
Leadership quality/potential              1          2              3            4               5
Alpha Xi Delta, campus, and/or
                                          1          2              3            4               5
community involvement
Relationship with peers and others        1          2              3            4               5
Acceptance of responsibility              1          2              3            4               5
Financial need                            1          2              3            4               5

Personal comments (required): Please include information you believe to be relevant in the
selection of this applicant, including knowledge of special needs. Attach additional sheets if
necessary.




Signature of alumna recommender                                                 Date
Name (please print)
Mailing Address
Phone                                 Email
Alpha Xi Delta role or volunteer position
Initiating chapter/initiation year                                      /
                                                        This section to be completed by applicant:
SCHOLARSHIP                                   Name_________________________________________
LETTER OF RECOMMENDATION
FORM                                              Address_______________________________________
to be completed by a current or former
employer or academician                           ______________________________________________

                                                  Phone_________________________________________
Must Be Postmarked By: March 15, 2012
                                                  Email_________________________________________


Instructions: The applicant will be considered for a scholarship from the Alpha Xi Delta
Foundation. Scholarships are awarded based on achievement, as well as need. To assist in the
selection process, it is requested that each applicant submit a letter of recommendation from a
current or former employer or academician that includes the following:

      length of time and capacity in which you have known the applicant;
      based on your relationship with the applicant, a description of how she makes a difference
       in her profession, community, and/or in the classroom;
      description of applicant’s relationship with peers and others;
      description of how the applicant accepts responsibility;
      any additional information you believe would be relevant in the selection of this applicant,
       including any knowledge of financial need; and
      your name and position (academicians please also include college/university).

               Letters of recommendation should be accompanied by this sheet.
This recommendation will remain strictly confidential. Your thoroughness and care in providing the
information requested are sincerely appreciated. Materials may be given to the applicant in a sealed
            envelope with your signature across the seal or you may send the letter by

                                    MAIL, FAX or EMAIL to:
                                    Alpha Xi Delta Foundation
                                      Attn: Claressa Basile
                                       8702 Founders Road
                                     Indianapolis, IN 46268
                                        Fax: 317.872.2947
                                   Email: cbasile@alphaxidelta.org



         DEADLINE: Letters of recommendation must be postmarked by March 15, 2012.


                         Questions? Contact Alpha Xi Delta Foundation at
                           317.872.3500 or cbasile@alphaxidelta.org.
                                   Financial Information
         Your estimated income and expenses for the 2012-2013 academic year
                         Income                                    Expenses
                                             Amount                          Amount
Employment                                  $24,000.00 Tuition & Fees        $ 9,000.00
From your family (amount your family
will contribute to your education)                      Room & Board        n/a live at home
Loans                                        $ 5,000.00 Books & Supplies       $ 800.00
                                                        Undergraduate
Scholarships, grants, awards                 $ 1,000.00 loan repayment       $ 2,400.00
Other income                                            Other expenses      $20,000.00

                     TOTAL INCOMES               $30,000.00               TOTAL
                                                                        EXPENSES           $32,200.00

    Please keep in mind that these are annual (12-month) figures. For example, for “Tuition & Fees”
    enter your costs for one academic year, not the total amount of a multi-year program. And for
    loan repayment, enter the amount that you intend to pay on your loan this year, not the total
    amount outstanding.

								
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