BPC Scholarship Application Form

BPC Scholarship Application Form

Application Deadline - April 30, 2025
Read and follow the instructions carefully prior to submitting your application. All applicants will be notified on or before May 30th. Once reciepients are confirmed they will be required to provide an enrollment verification form. If you have any questions or concerns please email us at: info@seattledeltas.org.

Delta Sigma Theta Sorority, Incorporated is an organization of college-educated women committed to the constructive development of its members and to public service with a primary focus on the Black community.

The Seattle Alumnae Chapter will award thousands in scholarships to young women graduating from high school and pursuing higher education. The scholarship honors Bertha Pitts Campbell, one of the 22 Founders of Delta Sigma Theta Sorority and a long-time Seattle resident who exemplified leadership, academic excellence and community service.

ELIGIBILITY FOR THE BERTHA PITTS CAMPBELL SCHOLARSHIP

To be eligible for a Bertha Pitts Campbell Scholarship, applicants must:

APPLICATION PROCEDURES FOR THE BERTHA PITTS CAMPBELL SCHOLARSHIP

Please note that the scholarship application includes several forms. All of the forms must be completed and submitted as one packet to be considered for the Bertha Pitts Campbell Scholarship. Incomplete applications and applications that are not submitted by April 30 will not be eligible.
I have read and understand the instructions.*

Yes
I certify that I read the qualifications in the instructions and I qualify to apply for this scholarship.*

Yes
If selected, you will be asked for documentation to support the data you provide. Likewise, all correspondence and award agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization and punctuation.
I. APPLICANT INFORMATION:

Tell us about yourself
Full Name*

First NameMiddle NameLast Name
Birthdate:*

MonthDayYear
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mobile No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Current High School:*
We would like to use awardees photos for historical and publicity purposes. If you are awarded a scholarship, do we have permission to use your photo?*

YesNo
How did you learn about this award?:

0/300
II. PARENT/GUARDIAN CONTACT INFORMATION:
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number

Area CodePhone Number
Parent/Guardian Email
example@example.com
III. PLEASE TELL US ABOUT YOU:
Please list the names of colleges, universities, and technical/trade schools where you have been accepted.*

In the space provided, please list your current school activities, athletics, hobbies and community service.*

	Name of Activity and/or organization	Years of Participation	Hours per week/ weeks per year	Leadership positions held And/or notes
Activity 1
Activity 2
Activity 3
Activity 4

Please select one activity from this list above and describe why it is meaningful to you or how you think it will help you advance your goals.*
Please list any awards and honors you have received in the past four years.*
IV. ESSAY INSTRUCTIONS:

*500 words max
(In 500 words or less) Please describe a significant challenge you have overcome in your life. How did this experience shape your character, values, and goals? Discuss how your resilience and determination will contribute to your academic success and future contributions to society. *

0/500
V. FINANCIAL INFORMATION:

Please be as thorough as possible when completing this portion of the application. All information is confidential.

1. Please tell us about your parent(s)/guardian(s).*

	Parent/Guardian Name	Occupation	Annual Salary (after taxes)
Parent 1
Parent 2
Parent 3
Parent 4

2. Please list siblings or other minors in your household.*

	Name	Age	School
Sibling 1
Sibling 2
Sibling 3
Sibling 4

3. Is your parent(s)/guardian(s) able to assist you financially during your freshman year?*

YesNo
4. If Yes, how much support will be provided?*

5. Please list all financial assistance/scholarships applied for or received to date. *

	Source	Amount Sought	Received (Yes or Pending)
Source 1
Source 2
Source 3
Source 4

6. What is your projected Budget for Freshman Year (Available Funds) ?*
6. What is your projected Budget for Freshman Year (Estimated Expenses) ?*
Please upload your unofficial transcript here:*

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*If you have technical difficulties uploading your application, please email your complete application package to scholarship@seattledeltas.org.
VI. APPLICANT'S DECLARATION:

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.
I, Your Full Name*have completed this application accurately and to the best of my ability.
Applicant's Signature*

Clear
VII. PARENT(S)/GUARDIAN CONFIRMATION :

By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the parent(s)/guardian of the student 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.
I, Your Full Name*confirm all financial information included in this application is current,
complete, and accurate..
Parent(s)/Guardian(s) Signature*

Clear
VIII. LETTERS OF RECOMMENDATION:

Below, please enter the names, titles, and email addresses of the two people who will be writing recommendation letters for you.
Name*

First NameLast Name
Title *
Email*
example@example.com
Name*

First NameLast Name
Title*
Email*
example@example.com
VIII-A. COMMUNITY SERVICE LETTER OF RECOMMENDATION:

Please upload one signed Letter of Recommendation as a PDF or Word Doc. Your letter should be signed and typed on letterhead.
Name

First NameLast Name
Title
Email
example@example.com
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BPC Scholarship Application Form

I. APPLICANT INFORMATION:

II. PARENT/GUARDIAN CONTACT INFORMATION:

III. PLEASE TELL US ABOUT YOU:

IV. ESSAY INSTRUCTIONS:

V. FINANCIAL INFORMATION:

VI. APPLICANT'S DECLARATION:

VII. PARENT(S)/GUARDIAN CONFIRMATION :

VIII. LETTERS OF RECOMMENDATION:

VIII-A. COMMUNITY SERVICE LETTER OF RECOMMENDATION:

VIII-B. SCHOOL LETTER OF RECOMMENDATION: