Ohio State Organization
Alpha Delta State Ohio Educational Foundation Scholarship Application
For members of Delta Kappa Gamma
Scholarship for which you are applying
Annie Webb Blanton (any accredited university)
Florence L. Woodward (Kent State University)
Ruth Grimes (Miami University)
Personal Data
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Your email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
OSO Chapter
*
Month and year of induction
*
Member ID
*
Years of teaching experience
*
Years at present position
*
Delta Kappa Gamma Involvement at each level
List ways involved
Chapter Involvement
*
State Involvement
*
International Involvement
*
Educational Information & Expenses
University/College you will attend
*
List semester(s) of enrollment
*
Total number of semester hours needed to complete degree/program/licensure:
*
Estimated cost of university fees & tuition
*
List (not a paragraph) university/college work in which you received credit hours. Include institution(s), date(s) of attendance, and degree(s)/certification.
*
In 250 words or less, share your plans for advanced study and how you plan to use your scholarship
*
Achievements
Scholarship(s) you have received
*
List (not a paragraph) membership and offices held in professional and civic organizations
*
Educational and professional honors received
*
References
Two letters of reference, on professional letterhead stationery, are required. Attach below. One reference must be from your current supervisor. One letter of reference may be submitted from a principal, supervisor, superintendent, co-teacher, advisor, or professor.
First Letter of Reference
*
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Second Letter of Reference
*
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Attach a photo head shot suitable for publication
*
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Additional Information
List additional information such as family obligations, or other criteria that the committee might need to consider.
Today's Date
*
-
Month
-
Day
Year
Date
Signature
*
Submit
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