2022-2023 DST AWVAC SCHOLARSHIP APPLICATION

2022-2023 DST AWVAC Scholarship Application

Deadline: Tuesday, February 28, 2023

Instructions

Thank you for your interest in applying for the

Delta Sigma Theta Sorority, Inc.

Arizona West Valley Alumnae Chapter Scholarship Award

We ask that you review our website: www.dstawvac.org, to learn more about our organization.

CLICK HERE TO ACCESS THE INSTRUCTIONS

We wish you the best in all of your educational pursuits!

Applicant Information
Name
Email Address
example@example.com
Address

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Gender

MaleFemaleNon-ConformingPrefer not to Respond
Date of Birth

MonthDayYear
Date
Age
Race/Heritage
Is your mother a member of Delta Sigma Theta Sorority, Inc.?

YesNo
Is your mother a member of DST AWVAC?

YesNo
Name of DST Member & Chapter

DST MemberName of Chapter

School Information
SCHOOL INFORMATION
High School/ College Currently Attending
Address of School

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Overall GPA
Date

MonthDayYear
Date
4 Year Institution Attending
Address of 4 Year Institution

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Major
Tuition Amount

Scholarship Background

List Other Scholarships Awarded: Scholarships awarded including those covering the period of aid requested in this application (Attach additional sheets if needed)

	Source	Date Award Covers From	Date Award Covers To	Annual Amount
Scholarship #1
Scholarship #2
Scholarship #3
Scholarship #4

Activities, Awards and Recognition

Community Service Activities : List your extra-curricular activity and/or related awards (if additional space is required attached (1) 8.5x11 typed sheet

	Organization	Dates	Level of Participation (Offices Held, etc.)
Community Service Activity #1
Community Service Activity #2
Community Service Activity #3
Community Service Activity #4

Extra-Curricular Activities : List your extra-curricular activity and/or related awards (if additional space is required attached (1) 8.5x11 typed sheet

	Organization	Dates	Level of Participation (Offices Held, etc.)
Extra-Curricular Activity #1
Extra-Curricular Activity #2
Extra-Curricular Activity #3
Extra-Curricular Activity #4

Awards/ Recognitions : List any awards or recognitions

	Organization	Dates	Level of Participation (Offices Held, etc.)
Awards/ Recognitions #1
Awards/ Recognitions #2
Awards/ Recognitions #3
Awards/ Recognitions #4

Additional Recognition

In the space above please add any additional scholarships, awards, extracurricular activities or community service activities: Include the date received, and either your role/position in the activity or purpose for receiving the award.0/200

Essay
ESSAY QUESTION

In the space above, please type a response in 500 words or less answering the following question: What do you consider to be the single most important societal problem in America and Why?0/500

Additional Documentation
Upload Recommendation Letters and additional documentation here- You may upload multiple documents

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Cancelof
I have submitted List # of Items and what they are using this form, and List # of items and what they are it will arrive via mail. Please contact me if you have not received them.
Documentation Checklist

I have requested my transcripts to be mailed to you.I have uploaded my 2 recommendation letters (academic and perosnal).I have uploaded by personal statement and additional information (if I needed additonal space).I have uploaded my resume.

Review Agreement and Signature
- I have met ALL eligibility requirements as outlined and acknowledge that misrepresenting the information presented may be grounds to rescind the scholarship award. I also agree to inform the scholarship committee of any significant changes to that information.
- I am willing to participate in a personal interview and forward any additional information.
- I agree to accept the decision of the Scholarship Committee of the Arizona West Valley Alumnae Chapter, Delta Sigma Theta Sorority, Inc.
- I will use the proceeds of any scholarship received for the payment of tuition, required fees, room and board, and/or required materials only.
- If selected to be awarded a scholarship, I will provide satisfactory evidence, as required by The Arizona West Valley Alumnae Chapter of Delta Sigma Theta Sorority, Inc., of my full-time enrollment during the period(s) for which the scholarship is awarded.
- I am willing to participate in the Arizona West Valley Alumnae Chapter, Delta Sigma Theta Sorority, Inc. Awards program (if applicable).
- I understand that submitting this application constitutes permission to use my name and/or photograph for promotional purposes in all Delta Sigma Theta Sorority, Inc. publications.
- I agree to the release of official transcripts of my grades to The Arizona West Valley Alumnae Chapter of Delta Sigma Theta Sorority, Inc.
Name of Applicant

First NameMiddle NameLast Name
Date

MonthDayYear
Date
Signature

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2022-2023 DST AWVAC Scholarship Application

SCHOOL INFORMATION