ACADEMIC SCHOLARSHIP APPLICATION
Congratulations on reaching this academic milestone!
Delta Sigma Theta Sorority, Inc., is an organization dedicated to aiding in the education of talented youth throughout our community. Each year, we award ten college scholarships as follows: one
Literary
Scholarship, four
Leadership
Scholarships, and five
Academic
Scholarships. For your convenience in completing your application packet, the following items are included below: Academic Scholarship Eligibility and Selection Criteria Academic Scholarship Application Form Dependent Acknowledgement Waiver Media Waiver
ACADEMIC SCHOLARSHIP ELIGIBILITY:
Must be an African-American female. Must have a
minimum unweighted G.P.A of 3.3 on a 4.0 scale
. Must demonstrate community involvement which will be assessed by the number of volunteer/community service hours listed on the transcript. If not listed on the transcript, official documentation is required. Must graduate from a Duval County (public, private, or charter) high school at the end of the 2021-2022 academic school year. Must attend an accredited institution of higher education after graduation and enroll as a full-time student. Must submit ACT and/or SAT college admission examination scores. Must submit an official high school transcript. Must submit
two (2) typed letters of recommendation
: One (1) letter must be from a high school staff member. One (1) letter must be from an organization in which you have performed community service. Both letters must be
signed
and on the appropriate
school/
organization’s letterhead
. Must submit a
1-page essay
. Requirements are listed below. Typed (in 12 pt Times New Roman font) Double-spaced 500-word maximum essay The essay
must
include a discussion on the following: How your academic achievements have prepared you for your future goals. Why you should be a recipient of the Academic Scholarship. A
detailed
description of the following points to substantiate your request Any special academic awards and achievements. Participation in extracurricular activities (including time spent and any leadership positions held). Active participation in community service.
Be sure to type your name in the heading at the top of the page. For example: Scholarship Essay by Jane Doe)
. Must submit a
headshot photo
(in JPG, PNG or similar format). High-resolution photos (minimum 300 dpi) are preferred. Student and parent/guardian must complete and sign the Scholarship Application. Student and parent/guardian must sign the attached Dependent Acknowledgement Waiver and Media Waiver.
SELECTION CRITERIA:
Students may only apply for ONE of the three types of scholarships offered.
Finalists will be selected by the Scholarship Committee based on all scholarship requirements submitted. A member of the Scholarship Committee will contact selected finalists to schedule an interview. Finalists must participate in the scheduled interview with the Scholarship Committee. Dependents of members of Delta Sigma Theta Sorority, Inc., are
ineligible
to participate in the scholarship.
SUBMISSION DEADLINE:
Applications should be submitted electronically (via the submit button below)
by no later than Saturday
,
March 26, 2022
. Please carefully review your application and all supporting documentation before submitting. Incomplete applications and those received after the deadline will NOT be considered by the Scholarship Committee. If you experience difficulty submitting your application electronically, you may print the form, complete it, and mail it (along with all of the supporting documentation) to the following address:
*
Delta Sigma Theta Sorority, Inc. Jacksonville Alumnae Chapter ATTN: Scholarship Committee P. O. Box 2435 Jacksonville, FL 32203
*
Please be advised that mailed submissions
must be postmarked by no later than March 26, 2022
. Should you have any questions, you may contact us at
dstjaxmayweek@gmail.com
.
Thank you for your interest in our scholarship offerings. We wish you success as you continue your academic career!
Please complete the form below.
Name
*
First Name
Last Name
Date of Birth
*
Email
*
example@example.com
Address
*
Street Address Line 1
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
-
Area Code
Phone Number
Home Phone Number
-
Area Code
Phone Number
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
example@example.com
Parent/Guardian Cell Phone Number
*
-
Area Code
Phone Number
Parent/Guardian Work Phone Number
-
Area Code
Phone Number
Is your parent/guardian a member of Delta Sigma Theta Sorority, Inc.?
*
Please Select
Yes
No
If you answered YES, please STOP HERE. You are ineligible for the scholarship.
High School
*
School Counselor Name
*
First Name
Last Name
GPA
*
Unweighted
Weighted
Do you receive free or reduced lunch?
Please Select
Yes
No
SAT (Total Score)
ACT (Total Score)
PLEASE READ THE FOLLOWING STATEMENTS AND SIGN BELOW:
The information provided in my application packet is, to the best of my knowledge, complete and accurate. I understand that any false statements in this application may disqualify me from consideration of the scholarship award(s). I also understand and agree that any and all information submitted as part of this application packet will become property of the Jacksonville Alumnae Chapter of Delta Sigma Theta Sorority, Inc., and will be kept confidential. By signing below, I agree to accept the decision of the scholarship committee.
Applicant Signature
*
First Name
Last Name
Parent/Guardian Signature
*
First Name
Last Name
DEPENDENT ACKNOWLEDGEMENT WAIVER
: I, the undersigned parent/guardian of the above-referenced applicant/participant, acknowledge that she/he is my dependent and that she/he is
NOT
a dependent of a member of Delta Sigma Theta Sorority, Inc., (locally, nationally, or at-large). I understand that dependents of members of Delta Sigma Theta Sorority, Inc., are
ineligible
to participate in the scholarship and cannot receive scholarship funds. If it is determined that the above-referenced applicant/participant is a dependent of a member of Delta Sigma Theta Sorority, Inc., any scholarship funds awarded and/or received will be forfeited and must be immediately returned in full to the Jacksonville Alumnae Chapter of Delta Sigma Theta Sorority, Inc.
BY MY SIGNATURE, I AM INDICATING THAT I HAVE READ AND UNDERSTAND THE FOREGOING INFORMATION.
Applicant/Participant Signature
*
First Name
Last Name
Parent/Guardian Signature
*
First Name
Last Name
MEDIA WAIVER:
I, the parent/guardian of the above-referenced applicant/participant consent to the release of photographs, videos, audio and other related recorded materials captured during the scholarship awards program. Such materials shall remain the sole property of the Jacksonville Alumnae Chapter of Delta Sigma Theta Sorority, Inc., and shall not be sold to any entity.
BY MY SIGNATURE, I AM INDICATING THAT I HAVE READ AND UNDERSTAND THE FOREGOING INFORMATION.
Applicant/Participant Signature
*
First Name
Last Name
Parent/Guardian Signature
*
First Name
Last Name
SAT and/or ACT Documentation
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High School Transcript
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Documented Proof of Volunteer/Community Service Hours (if the hours are not listed on the transcript)
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Letter of Recommendation (High School Staff Member)
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Letter of Recommendation (Community Service Organization)
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Essay
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Headshot Photo
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