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Alpha Delta Kappa Scholarship Application

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					          Alpha Delta Kappa Scholarship Application


Please include the following:

1. application form, fully completed

2. one-page essay discussing your desire to become a
   teacher.

3. high school transcripts

4. college transcripts (if applicable)
5. two sealed letters or recommendation from teachers,
   employers, or other non-family members
6. Counselor’s sheet


Applications must be received by April 15, 2011

Send your completed application to:

Debbie Plummer
1139 Crescent Ave
Klamath Falls, Or 97601
       Alpha Delta Kappa Scholarship Application 2011
                                  Applicant Information


Application Date      /       /        School
Age                                          Grade

Last Name                     First Name                    Middle Name

Street Address                       City                   State          Zip
Home Phone

The information I have provided is true and accurate to the best of my knowledge.


Student Signature


Activities

School :_______________________________________




Discuss your participation in one school activity, your contribution, and the benefit to
       you:




                                                                                           2
Community, Church and other activities:




Work experience:




                                          3
            Alpha Delta Kappa Scholarship Application
                             2011


Must be completed by high school counselor/or college advisor


School________________________________________


GPA______________________________
Class Rank________________________


S.A.T. Scores                    math_____________
   *if in HS                     verbal___________
                                Total______________

A.C.T. composite               ___________________
*if in HS

Counselor’s name_____________________________

Work phone_________________________________

Counselor’s signature




                                                                4