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DELTA-SIGMA-THETA-SORORITY-APPLICATION-2011

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					                             DELTA SIGMA THETA SORORITY, INC.
                             LOS ANGELES ALUMNAE CHAPTER
                                           2010-2011
        SCHOLARSHIP APPLICATION



                                                                                      ATTACH PHOTO



 DIRECTIONS: Please type or print                                  HERE

 NAME: ___________________________________________________________________________________
             (Last)                       (First)                (Middle)

 ADDRESS: ___________________________________________________PHONE:_______________________
             (Street)              (City/Zip)                    (Area Code)

 BIRTHDATE: ________________________________________GRADUATION DATE: _________________
            Month       Day       Year

 HIGH
 SCHOOL______________________________________________PHONE:_________________________
           (Name)              (Address)      (Zip)              (Area Code)

 COLLEGE ADVISOR’S NAME:
 _________________________Phone:___________________________________

 GRADE POINT AVERAGE:__________SAT/ACT
 SCORES:_______(V)_______(M)_________________________
                                    (Attach copy of SAT/ACT highest,          Date Taken
                                      scores if NOT recorded on Transcript)
 HONORS:__________________________________________________________________________________


 HIGH SCHOOL
 ACTIVITIES:_____________________________________________________________________

 COMMUNITY
 ACTIVITIES:______________________________________________________________________

 LIST ANY OUTSIDE JOBS YOU HAVE HELD WHILE IN HIGH SCHOOL (Including Year)


 COLLEGE YOU PLAN TO ATTEND:
1.______________________________________________________________

2.____________________________________________________________________________________________
      ANTICIPATED COLLEGE MAJOR:
      _______________________________________________________________

      CAREER OBJECTIVES/GOALS:
      1.______________________________________________________________

      2.______________________________________________________________



      DELTA SIGMA THETA SORORITY, INC.                                                    Page 2

      NAMES OF REFERENCES: (1)____________________________________________________________
      (May be same as those who wrote (Name)                             (Phone)
       letters of recommendation.)
                                           (2)____________________________________________________________
                                                   (Name)                                (Phone)

                                           (3)____________________________________________________________
                                                 (Name)                                  (Phone)

      MOTHER’S/GUARDIAN’S
      NAME:_____________________________ADDRESS_________________________

      OCCUPATION:________________________________YEARLY INCOME:________PHONE:____________
                                                                           (Area Code)

      FATHER’S/GUARDIAN’S
      NAME:_____________________________ADDRESS__________________________

      OCCUPATION:_______________________________YEARLY
      INCOME:_______PHONE:_______________
                                                                                                   (Area Code)

        Names of Sisters and/or Brothers
        who will be claimed by your                    Name of Present                                  Grade level in School
        Parents as U.S. Tax Exemptions          School or College                  or Year in College

      A._______________________________________          _____________________________       ___________________________


      B._______________________________________         _____________________________       ____________________________


      C._______________________________________          ____________________________       ________________________


      D.______________________________________         ____________________________       _____________________________


      E._______________________________________        ____________________________       ____________________________

      LIST ANY OTHER SCHOLARSHIPS OR GRANTS FOR WHICH YOU APPLIED:

      A.__________________________________________________________________________________________________________

      B.__________________________________________________________________________________________________________

      C.__________________________________________________________________________________________________________

PLEASE INDICATE THE TYPE OF SCHOLARSHIP FOR WHICH YOU WISH TO BE CONSIDERED (CHECK ONE OR BOTH)
FINANCIAL ASSISTANCE ____                   ACADEMIC EXCELLENCE ____
I certify that all information provided is true and correct.
     __________________                                          _____________
               SIGNATURE                                                      DATE
     **Are you attending a prom? What date/dates? Question is for the purpose of scheduling
     interviews.
     **REPRODUCE IF NECESSARY

				
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