Covington Area Alumnae Chapter Scholarship Application Form

Academic Scholarship Eligibility Requirements:
1. Applicant must be a high school senior (male or female) who resides in or attends a high school in one of the following areas:
  - Newton County: Covington (30014, 30015, 30016) Oxford (30054), Porterdale (30070), Mansfield (30055), Newborn (30056),
  - Walton County: Good Hope (30641), Jersey (30018), Monroe (30655, 30656), Social Circle (30025)
2. Applicant must have a minimum of 2.5 cumulative grade point average on a 4.0 scale and plan to attend a college, university, junior college, or technical school.
3. Applicant must be African American to apply.
4. The applicant must submit a completed application packet by February 15, 2026 which includes the following:
- A complete application form
- A 350-500 word essay
- An official transcript from your current high school
- Two references: one from a school official (an administrator, teacher, counselor, etc.); and one from a community representative (non-family member) ***Must include the reference's email addresses.
- COMPLETED COUNSELOR VERIFICATION FORM. Click here for access to the form.
Important Submission Information:
1. Omission of any part of the application will eliminate the application from consideration.
2. The highest-scoring applicants will be selected for an interview.
3. Scholarship recipients are asked to attend an Awards Presentation Ceremony scheduled by the scholarship committee.
4. Scholarships will be awarded upon verification of enrollment into a college, university, junior college, or technical school.
5. Scholarship checks will be made payable to the recipient.
I. Personal Data:
Full Name*

First NameMiddle NameLast NameSuffix
Birthdate:*

MonthDayYear
Cell Phone:*
E-mail :*
Where the confirmation will be sent
Home Address :*

Street Address

Street Address Line 2

CityState

Postal / Zip Code
Gender:

MaleFemaleNon-Binary/OtherDo not wish to answer
Parent/Guardian 1 Name

First NameLast Name
Parent/Guardian 1 Email
example@example.com
Parent/Guardian 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 1 Phone Number
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Address (if different than above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian 2 Phone Number

Covington Area Alumnae Chapter of Delta Sigma Theta Sorority, Inc. Scholarship Application Form

Application Deadline - February 15, 2026
II. Education Information
Name of High School
School Address

Street Address

Street Address Line 2

CityState

Postal / Zip Code
School Phone Number
Cumulative Grade Point Average (on a 4.0 scale):
GPA
III. Honors, Special Talents, Work Experience

List Honors and Awards (academic, church, community, and/or sports)
List Extracurricular Activities - Organizations and Clubs (Indicate years of involvement and any offices held)
List Community Involvement Activities
List any work experience (give the job title, employer and dates of employment, beginning with your current or most recent job)
Work Experience
Describe other work experiences (such as family business or helping at home)
List the name(s) of any programs sponsored by the Covington Area Alumnae Chapter of Delta Sigma Theta Sorority, Inc. that you have participated in.

IV. Essay:
Scholarship Essay Question Choices: Using 350-500 words, select ONE essay question to respond to. Be sure to answer in complete sentences. 1) Explain why you want to be a recipient of the Covington Area Alumnae Chapter’s Academic Scholarship. Include your aspirations for the future and tell us how you plan to utilize the funds to make a difference in the world. 2) High School is a period of personal and social development. Discuss how your involvement in your school and community activities has shaped who you today and influenced your future goals?
Essay

V. References

References will be contacted directly to submit a reference on your behalf. References from relatives will not be accepted. At least one reference must be from an official at the school you currently attend. The applicant is responsible for the accuracy of all reference contact information. Please include their information below.
Reference #1 Name

First NameLast Name
Email
example@example.com
Phone Number
Reference #2 Name

First NameLast Name
Phone Number

Email
example@example.com
VI. High School Transcript

An official high school transcript must be submitted. It must include the first semester grades of the senior year and must be sent from a school official via email to scholarship.caac@gmail.com or uploaded below.
OFFICIAL TRANSCRIPT: Upload your high school transcript here

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VII. Counselor Verification Form

A Counselor Verification Form must be sent from a school official via email to scholarship.caac@gmail.com, uploaded below or mailed to: Scholarship Committee Covington Area Alumnae Chapter Delta Sigma Theta Sorority, Inc. P.O. Box 478 Oxford, GA 30054. To obtain a copy of the Counselor Verification Form, please refer to the "Instructions" section above.
File Upload

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VIII. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application submission.
E-Signature:*
Should be Empty:

I. Personal Data:

Covington Area Alumnae Chapter of Delta Sigma Theta Sorority, Inc. Scholarship Application Form

II. Education Information

III. Honors, Special Talents, Work Experience

IV. Essay:

V. References

VI. High School Transcript

VII. Counselor Verification Form

VIII. Applicant's E-Signature