SCHOLARSHIP APPLICATION - Get Now DOC

							                             SCHOLARSHIP APPLICATION

                                     BETA STATE

                      DELTA KAPPA GAMMA SOCIETY INTERNATIONAL



Scholarship(s) sought: $3100         $700



Institutional data

Name of university:

Address:

Degree sought:                                    Major:

Location of your courses:

   Online university                 Online program                    Residential requirement

Residential time required:                                 Location:

University certification:

Program certification:



Personal Data

Name:

Address:

Phone: Home:                 Work:                         email:

Birthdate:                                  Marital Status:
Post Secondary Education

        Institution             Degree        Year       Major




Work Experience

      Employer                 Position          Employment Dates




Community activities

    ORGANIZATION           SERVICE POSITION           DATES
MEMBERSHIP AND SERVICE TO DELTA KAPPA GAMMA

Chapter:                       Location:                       District:

Initiation Date:                                            Years of membership:



Chapter Service:

  Biennium            Office                   Committee                     Other Service




District , State, International Service (Director, Officer, Committee Member):

  Biennium               District                      State                     International
Participation Record (Attendance):

                      Event                  Dates Attended

District Meeting(s)

Beta State Convention(s)

Beta State Leadership Seminar

Regional Conference(s)

International Convention(s)

Golden Gift Leadership/Management Seminar



Achievements

Publications:




Honors, Scholarships, Fellowships, Grants:
References



     1.
          (Current chapter president or chapter president when you served as primary officer)



     2.
          (Supervisor in the educational system of your employment)



     3.
          (Character reference of your choice)



     4.
          (Doctoral students only. Major professor or chair of doctoral committee. This letter indicates official
          acceptance into doctoral program, progress in the program, and anticipated date of completion)



These letters are to be mailed to the current Beta State Scholarship Chair, and postmarked no later than February 1



Previous applications
No            Yes          If yes, complete the following.

Scholarship                    Date Applied                  Amount                         Check if awarded
Revised 09-2009