Helen Lemme Scholarship Application

Des Moines Alumnae Chapter

Delta Sigma Theta Sorority, Inc.
HELEN LEMME SCHOLARSHIP APPLICATION
ATTENTION: AFRICAN AMERICAN STUDENTS
If you are a high school graduating senior and live in the toll-free calling area of Des Moines and Boone, Iowa, you are eligible to apply for this scholarship. To be considered, you MUST do all of the following:
1. Have a minimum cumulative GPA of 2.5
2. Submit an application online or print the application and submit a typed application via the U.S. postal service.
3. Submit two (2) letters of reference from individuals who are not relatives.
  At least one letter of reference must be from a current or former teacher.
  Letters should include specifics on the student's academic performance, how they adapt socially and their overall attitude about school and their future
4. Submit an OFFICIAL copy of your high school transcript from the registrar.
5. Copies WILL NOT be accepted if they state “Issued to the student.” The transcript should identify your African American or Black heritage.
6. Submit a typed one page essay discussing your future plans and why you feel you deserve the Helen Lemme Scholarship. The essay should be 1 page. Essays should be typed using Times New Roman, 12-point font, and double spaced.
7. Submit a recent photograph along with the consent to publish.
8. Participate in a ZOOM interview.
If you submit your application via mail, you can mail your essay, transcript, and letters of reference to the address listed below.

You will receive a confirmation email once all parts of your application are received.

Des Moines Alumnae Chapter

Scholarship Committee Attn: Maria J. Barnes

P.O. Box 4706

Des Moines, IA 50305

The application packet must be submitted online or postmarked on or before April 15, 2022

For additional information, contact Maria J. Barnes at dsmdstscholarships@gmail.com

Only High School SENIORS Are Eligbile
Student Information
Student Name

First NameLast Name
Student Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Phone Number
Please enter a valid phone number.
Student Email
example@example.com

Application Materials
Essay

The essay should be 1 page explaining your future plans and why you deserve the Helen Lemme Scholarship. Essays should be typed using Times New Roman, 12-point font and double spaced
Essay Upload

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School and Community Involvement (Please list and describe. You may also attach a resume or additional word document/.PDF)
Resume or Additional Document(s) for School and Community Involvement

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Official High School Transcript

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Current Photograph

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School/Financial Information
College Plans
Indicate choice of higher education/training

Vocational/Trade SchoolCommunity CollegeUniversity or College (four year)
Name of institution(s) to which you are applying, applied or are attending.
List no more than three (3) in priority order
Name of other financial assistance for which you have made application

Family Financial Assistance:
Did you complete the Family Financial Assistance Form? (i.e. FAFSA form)

YesNo
How much are you expected to pay toward your college expenses?
How much are your parents/guardians, if applicable, expected to pay?
Other Scholarships and Grants: (List all those for which you have applied. Upload additional document if necessary
Additional Scholarship and Grant Document(s)

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Employment Opportunities - Do you plan to seek employment to help finance your education? Please explain.

References
Please list names and addresses of two (2) references

One must be a current or former teacher (not related)
Reference #1 - Current or Past Teacher
Reference #1 Name

First NameLast Name
Reference #1 Relationship to Applicant
Reference #1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference #1 Phone Number
Please enter a valid phone number.
Reference #1 Email Address
example@example.com
Reference #1 Recommendation Letter (must be signed with actual signature, no font signatures)

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Reference #2 - Employer, Mentor, Pastor, Family Friend, Teacher
Reference #2 Name

First NameLast Name
Reference #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference #2 Phone Number
Please enter a valid phone number.
Reference #2 Email Address
example@example.com
Reference #2 Recommendation Letter (must be signed with actual signature, no font signatures)

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Parent/Guardian Information
First Parent/Guardian Information
Parent/Guardian Name

First NameLast Name
Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Occupation
Total Annual Household Income (including SSI, Military Benefits, FiP, Retirement, Pension, Child Support)
Second Parent/Guardian Information (if applicable)
Parent/Guardian Name

First NameLast Name
Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Occupation
Total Annual Household Income (including SSI, Military Benefits, FiP, Retirement, Pension, Child Support)
Number of other dependents in the home
Number of other family members in the home that attend college
Relationship to Applicant
Education History (list last school attended)
* Income must be included for application to be considered

Information in this application is confidential and shared only with

members of the Scholarship Committee.

Application Check-List

Completed applications must be submitted online or postmarked by March 22, 2021.

Contact Maria J. Barnes at dsmdstscholarships@gmail.com. If you have not received a confirmation email one (1) week after submitting your complete application.
Application Check-list

Current High School SeniorCompleted, signed and dated application. The application must be typed if printed and mailedEssay1 Reference letter from current or past teacher1 Reference letter from employer, mentor, pastor, family friend, teacher (cannot be related)Official High School TranscriptCurrent photographConsent to have photograph published on Des Moines Alumnae website

NOTE: Incomplete applications will not be reviewed.
By signing and dating below:

I certify that the information provided in this application is true, complete and accurateI certify that I am a graduating seniorI certify that I am African-AmericanI certify that all statements and essays submitted are my own workI consent to having my photograph published on the Des Moines Alumnae website
Applicants Signature (sign using your finger or mouse)

Clear
Date

MonthDayYear
Date
Thank you for your interest in Delta Sigma Theta Sorority’s Helen Lemme Scholarship
Should be Empty:

Des Moines Alumnae Chapter

HELEN LEMME SCHOLARSHIP APPLICATION

ATTENTION: AFRICAN AMERICAN STUDENTS

Student Information

Application Materials

School/Financial Information

References

Parent/Guardian Information

First Parent/Guardian Information

Second Parent/Guardian Information (if applicable)