HACScholarship22

Hattiesburg Alumnae Chapter Delta Sigma Theta Sorority, Inc

$1,000 Scholarship Application
I. Student Information
Name*
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Father's Name*
Father's Employer/Title*
Mother's Name*
Mother's Employer/Title*
II. High School Information
High School Attending*
School Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
School Telephone*
III. College Information
College Choice*
College Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
College Telephone*
IV. ESSAY/BRIEF AUTOBIOGRAPHY- PERSONAL ASPIRATIONS/CAREER GOALS.
In 250 to 500 words, please describe your intended college major, career objective, and how you expect to contribute to society. Please express within this essay the importance the Delta Sigma Theta Sorority Inc. scholarship assistance would have for you in meeting these goals.*

0/500
V. VOLUNTEER/SCHOOL ACTIVITIES/WORK EXPERIENCE
School Organizations/Clubs/Sports*
Indicate any offices held & years of involvement
Honors & Awards*
Community/Church or Other Activities*
Are you employed?*

YesNo
If yes, what type of work and how many hours?
VI. Letters of Recommendation

Letters must be typed and signed with position stated.
High School Teacher/Administrator Recommendation*
Leadership and Character Recommendation from Non-relative*
Community Service Recommendation*
Guidance Counselor Form (Completed & Signed by Counselor)*
Wallet Sized Photo/Head Shot*
VII. Certification
I will graduate this spring and plan to continue my education in college starting fall of 2023. If I am a chosen recipient of this scholarship, I understand that in order to accept the award I must attend a 2-or 4-year accredited college/university. I certify that all the information on this form is true and complete to the best of my knowledge.
Applicant's Signature*

Clear
Should be Empty:

I. Student Information

II. High School Information

III. College Information

IV. ESSAY/BRIEF AUTOBIOGRAPHY- PERSONAL ASPIRATIONS/CAREER GOALS.

V. VOLUNTEER/SCHOOL ACTIVITIES/WORK EXPERIENCE

VI. Letters of Recommendation

VII. Certification